Active NPI
Samantha Catherine Ruddy, M.D.
- Infectious Disease Physician
- Bronx, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 318420
- Practice address
- 2015 Grand Concourse
Bronx, NY 10453-4303 - Phone
- (718) 299-7295
- Fax
- (718) 299-6797
- NPI assigned
- Apr 20, 2017
- Reactivated
- Dec 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 318420 | NY | Primary |
Addresses
Primary practice location
2015 Grand Concourse
Bronx, NY 10453-4303
Mailing address
2626 Halperin Ave
Bronx, NY 10461-2631
Phone (718) 618-0401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Infectious Disease
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1080 Sunrise Hwy
Amityville, NY 11701-2526
Phone (631) 716-9026
3360 Route 343
Amenia, NY 12501-5619
Phone (845) 838-7038
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 318420 | NY | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Essen Medical Associates, PC | Current | Accepting new patients | |
| Sun River Health Inc | Current | Accepting new patients | |
| Essen Medical Associates, PC | Current | Accepting new patients | |
| Bronx Medical Practice P.C. | Current | Accepting new patients | |
| Sun River Health Inc | Current | Accepting new patients | |
| Sun River Health Inc. | Current | Accepting new patients |
Locations
3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006
6 Henry St
Beacon, NY 12508
Phone (845) 831-0400
2015 Grand Concourse
#13202
Bronx, NY 10453
2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400
2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200
2412 Church Ave
Brooklyn, NY 11226
Phone (347) 404-5950
8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- samantha.ruddy@hrh.eclinicaldirectplus.com
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- Amenia, NY
- NPI 1568526838
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1356726087
-
- Legal Medicine
- Bronx, NY
- NPI 1366418709
-
- Podiatrist
- Bronx, NY
- NPI 1720799158
-
- Adult Day Care Clinic/Center
- Bronx, NY
- NPI 1740763275
-
- Federally Qualified Health Center (FQHC)
- Peekskill, NY
- NPI 1619969458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660694400000",
"number": "1972037596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2626 HALPERIN AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104612631",
"telephone_number": "718-618-0401",
"fax_number": "347-479-1303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104534303",
"telephone_number": "718-299-7295",
"fax_number": "718-299-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDDY",
"first_name": "SAMANTHA",
"middle_name": "CATHERINE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-20",
"last_updated": "2022-08-17",
"certification_date": "2022-08-17",
"deactivation_date": "2017-11-27",
"reactivation_date": "2017-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NY",
"license": "318420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.