RUTH KURNIAWATI (NPI# 1669898565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669898565 |
| Entity Type | Individual |
| Full Name | RUTH KURNIAWATI |
| Credential | PA-C |
| Practice Address |
50 Wason Ave Springfield MA 01107-1132 |
| Mailing Address |
3640 Main St 103 Springfield MA 01107-1139 |
| Practice Telephone | 4137942222 |
| Practice Fax Number | 4137941666 |
| Mailing Telephone | 4137855321 |
| Mailing Fax Number | 4137317130 |
| Enumeration Date | 2014-03-16 |
| Last Update Date | 2015-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA4974 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
50 WASON AVE |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265413009 | Anastasios G Angelides | Pediatrics | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2005-11-09 |
| 1932727203 | Georgianna Rose Shea | Nurse Practitioner | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2020-07-13 |
| 1588118350 | Courtney Manning | Genetic Counselor, MS | 50 Wason Ave, Springfield, MA 01107-1274 | 2016-08-10 |
| 1457708455 | Samantha Mccarthy | Dietitian, Registered | 50 Wason Ave, Springfield, MA 01107-1274 | 2016-05-19 |
| 1881057800 | Baystate Developmental Behavioral Pediatrics | Psychologist | 50 Wason Ave, 1st. Floor, Springfield, MA 01107-1274 | 2016-03-29 |
| 1912370438 | Brenda Peters | Behavioral Analyst | 50 Wason Ave, Springfield, MA 01107-1132 | 2015-11-05 |
| 1053795351 | Shayl Griffith | Student in an Organized Health Care Education/Training Program | 50 Wason Ave, Springfield, MA 01107-1132 | 2015-07-16 |
| 1043620859 | Lisa Laprade | Dietitian, Registered | 50 Wason Ave, 1st Floor, Springfield, MA 01107-1132 | 2014-05-01 |
| 1245650225 | Baystate Pharmacy | Pharmacy | 50 Wason Ave, Springfield, MA 01107-1132 | 2014-04-17 |
| 1629409875 | Baystate Medical Center, Inc. | Pharmacy | 50 Wason Ave, Springfield, MA 01107-1132 | 2013-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740702547 | Domingo Nieves Jr. | Counselor | 2225 Main St., Springfield, MA 01107 | 2017-07-13 |
| 1801318266 | Denise Lawson | Counselor | 2257 Main Street, Springfield, MA 01107 | 2017-07-07 |
| 1568912491 | Trina Cysz | Nurse Practitioner | 101 Wason Avenue, Commonwealth Care Alliance, Springfield, MA 01107 | 2016-10-04 |
| 1609322262 | Toheeb Oladimeji Bakare | Counselor | 322 Birnie Avenue, Springfield, MA 01107 | 2016-09-01 |
| 1952701161 | Jalissa Sostre | Counselor | 32 Abbe Ave, Springfield, MA 01107 | 2014-08-26 |
| 1659799161 | Elizabeth A. Otmaskin | Obstetrics & Gynecology | 3455 Main Street Suite C, Baysttate Ob Gyn Group Inc, Springfield, MA 01107 | 2014-04-01 |
| 1205268885 | Catherine Matejcek Davies | Counselor | 246 Park Street, Springfield, MA 01107 | 2013-08-06 |
| 1750723268 | Jasdeep S. Badwal | Allergy & Immunology | 2 Medical Center Dr Ste 406, Springfield, MA 01107 | 2013-07-25 |
| 1255691846 | Medical Express Urgent Care Center, Co. Inc. | Physical Medicine & Rehabilitation | 438 Chestnut Street, Springfield, MA 01107 | 2012-05-17 |
| 1205166642 | Matthew R Kelley | Audiologist | 100 Wason, Suite 100, Springfield, MA 01107 | 2010-01-07 |
| Find all providers in zip 01107 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123289 | Jared Anthony Dias | Physician Assistant | 52 Devens St, Springfield, MA 01151-2304 | 2020-04-16 |
| 1659990976 | Maham Siddiqui | Physician Assistant | 8632 Hillside Manor Dr, Springfield, VA 22152-2238 | 2020-04-16 |
| 1558994772 | Kayla Rice | Physician Assistant | 3640 Main St Ste 103, Springfield, MA 01107-1139 | 2020-02-17 |
| 1487286563 | Michayla Marcil | Physician Assistant | 280 Chestnut St Fl 2, Springfield, MA 01199-1001 | 2020-02-06 |
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1023670593 | Michael Peter Lembotesis | Physician Assistant | 629 Evans Rd, Springfield, PA 19064-3033 | 2019-07-03 |
| 1245795558 | Alexandra Marie Cutler | Physician Assistant | 1437 S Gelven Ave, Springfield, MO 65804-2124 | 2019-01-31 |
| 1598265894 | Kelsey L. Magill | Physician Assistant | 3231 S National Ave Ste 440, Springfield, MO 65807-7304 | 2018-02-14 |
| 1447759592 | Darrell Dewain Edwards | Physician Assistant | 4350 S National Ave Ste C200, Springfield, MO 65810-2782 | 2018-02-05 |
| 1164930087 | Ashley Jean Nichole Leutze | Physician Assistant | 1164 E Home Rd Ste J, Springfield, OH 45503-2726 | 2018-01-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.