Individual provider Active NPI

Sade Solola Nussbaum, MD

  • Cardiovascular Disease Physician
  • Valhalla, NY
National Provider Identifier
1972036580
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD19276 Issued in RI
Practice address
100 Woods Rd
Valhalla, NY 10595-1530
Phone
(914) 493-6608
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD19276 RI
Cardiovascular Disease Physician 207RC0000X MD19276 RI Primary

Addresses

Primary practice location

100 Woods Rd
Valhalla, NY 10595-1530

Mailing address

100 Woods Rd Ste 100
Macy Pavillion: Suite 100
Valhalla, NY 10595-1530
Phone (914) 493-6608

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5891

Other names 1

  • Sade Solola Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD19276RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Sep 9, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital CurrentSince Jul 1, 2023 Accepting new patients
Rhode Island Hospital Cardiovascular Disease CurrentSince Sep 9, 2023 Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Jul 1, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
The Miriam Hospital Current Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

950 Warren Ave
Fl 2
East Providence, RI 02914

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Bldg 1ST
Providence, RI 02903

593 Eddy St
Providence, RI 02903

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1972036580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS RD STE 100",
            "address_2": "MACY PAVILLION: SUITE 100",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-6608",
            "fax_number": "401-444-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-6608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5891",
            "fax_number": "401-444-8158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOLA NUSSBAUM",
        "first_name": "SADE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD19276",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD19276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SADE",
            "last_name": "SOLOLA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Valhalla, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.