Active NPI
Rudiney Jeferson Daruge, MD
- Oral & Maxillofacial Surgery (D.M.D.)
- Brooklyn, NY
National Provider Identifier
1982416848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- 11053063
- Practice address
- 815 Flatbush Ave Unit 503
Brooklyn, NY 11226-3101 - Phone
- (407) 536-1134
- Fax
- (260) 235-5077
- NPI assigned
- Jan 27, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | 11053063 | FL | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 11053063 | FL | Primary |
Addresses
Primary practice location
815 Flatbush Ave Unit 503
Brooklyn, NY 11226-3101
Mailing address
815 Flatbush Ave Unit 503
Brooklyn, NY 11226-3101
Phone (407) 536-1134
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11053063 | FL | MD | Oral & Maxillofacial Surgery (D.M.D.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737936000000",
"number": "1982416848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 FLATBUSH AVE UNIT 503",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112263101",
"telephone_number": "407-536-1134",
"fax_number": "260-235-5077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 FLATBUSH AVE UNIT 503",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112263101",
"telephone_number": "407-536-1134",
"fax_number": "260-235-5077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARUGE",
"first_name": "RUDINEY JEFERSON",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-27",
"last_updated": "2025-01-27",
"certification_date": "2025-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "FL",
"license": "11053063",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Oral & Maxillofacial Surgery",
"state": "FL",
"license": "11053063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.