RUTH KURNIAWATI


Address: 50 Wason Ave, Springfield, MA 01107-1132
Phone: 4137942222

RUTH KURNIAWATI (NPI# 1669898565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA4974 MA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 50 WASON AVE
City SPRINGFIELD
State MA
Zip Code 01107-1132

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City SPRINGFIELD
Zip Code 01107

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Dataset Information

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.

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