DR. CARLOS ALBERTO RUEDA MD
Complete NPI Record 1366490195
Psychiatry & Neurology - Geriatric Psychiatry in Port Chester, NY
Active since May 04, 2006PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Dr. Carlos Alberto Rueda, MD (NPI 1366490195), an individual psychiatry & neurology provider in Port Chester, NY. All 35 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1366490195 Field 1/35
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/35
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: RUEDA Field 3/35
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: CARLOS Field 4/35
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: ALBERTO Field 5/35
- The middle name of the provider, if the provider is an individual.
- Provider Name Prefix Text: DR. Field 6/35
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: MD Field 7/35
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 14 EASTHAVEN LN Field 8/35
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: WHITE PLAINS Field 9/35
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NY Field 10/35
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 106055460 Field 11/35
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/35
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 9179726771 Field 13/35
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 25 S REGENT ST Field 14/35
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: PORT CHESTER Field 15/35
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NY Field 16/35
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 105733512 Field 17/35
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/35
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 9179726771 Field 19/35
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 22/35
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 2084P0805X Field 23/35
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 204047 Field 24/35
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: NY Field 25/35
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 26/35
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 2084P0800X Field 27/35
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: ME140892 Field 28/35
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: FL Field 29/35
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 30/35
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 01690582 Field 31/35
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 32/35
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: NY Field 33/35
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: Y Field 34/35
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 16
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
25 Pompton Ave, suite 308
Location 1/16Verona, NJ 07044 · Phone (608) 313-7083
7301A W Palmetto Park Rd Ste 307C
Location 2/16Boca Raton, FL 33433-3409 · Phone (561) 705-0253
1890 W County Road 419 Ste 1020
Location 3/16Oviedo, FL 32765-4402 · Phone (407) 720-6536
635 Primera Blvd Ste 121
Location 4/16Lake Mary, FL 32746-2173 · Phone (407) 720-6486
1210 E Osceola Pkwy Ste 203&204
Location 5/16Kissimmee, FL 34744-1621 · Phone (407) 961-6602
1950 Route 70 E Ste 201
Location 6/16Cherry Hill, NJ 08003-2128 · Phone (856) 229-0138
151 Fries Mill Rd Ste 101
Location 7/16Turnersville, NJ 08012-2056 · Phone (856) 229-0138
310 Central Ave Ste 105
Location 8/16East Orange, NJ 07018-2838 · Phone (862) 658-7190
1423 Tilton Rd Ste 6
Location 9/16Northfield, NJ 08225-1857 · Phone (609) 697-7933
1400 Route 70 E Fl 2
Location 10/16Cherry Hill, NJ 08034-2240 · Phone (856) 475-6497
45 Essex St Ste 200
Location 11/16Millburn, NJ 07041-1668 · Phone (973) 840-8517
240 Frisch Ct Ste 105
Location 12/16Paramus, NJ 07652-5249 · Phone (551) 230-2425
25 Pompton Ave Ste 308
Location 13/16Verona, NJ 07044-2939 · Phone (608) 352-4265
240 Frisch Ct Ste 101
Location 14/16Paramus, NJ 07652-5249 · Phone (201) 472-5448
60 Essex Street
Location 15/16Millburn, NJ 07041 · Phone (973) 339-0742
976 Lake Baldwin Ln Ste 102
Location 16/16Orlando, FL 32814-6687 · Phone (407) 753-4615
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
01690582 Medicaid
Identifier 1/1State: NY
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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