Individual provider Active NPI

Maris Roalsvig

  • Specialist
  • Niagara Falls, NY
National Provider Identifier
1043083710
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1762876231 Issued in NY
Practice address
9812 Lockport Rd
Niagara Falls, NY 14304-1114
Phone
(716) 297-1478
NPI assigned
Nov 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1762876231 NY Primary

Addresses

Primary practice location

9812 Lockport Rd
Niagara Falls, NY 14304-1114

Mailing address

9812 Lockport Rd
Niagara Falls, NY 14304-1114
Phone (716) 297-1478

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

State licenses

LicenseStateTypeSpecialty
1762876231NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1043083710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9812 LOCKPORT RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041114",
            "telephone_number": "716-297-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9812 LOCKPORT RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041114",
            "telephone_number": "716-297-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROALSVIG",
        "first_name": "MARIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1762876231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.