Individual provider Active NPI

Elizabeth Lacey Roberts, PSYCH CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Corning, NY
National Provider Identifier
1053284596
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP033921 Issued in PA
Practice address
145 Chemung St
Corning, NY 14830-2735
Phone
(570) 250-7837
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 407737 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP033921 PA Primary

Addresses

Primary practice location

145 Chemung St
Corning, NY 14830-2735

Mailing address

145 Chemung St
Corning, NY 14830-2735
Phone (607) 438-8996

Other names 1

  • Elizabeth Roberts Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305001534 NY Practitioner - Nurse Practitioner 8527540897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penfield Psychiatry PCGroup PAC ID 2365693264, 24 clinicians

Practice addresses (Care Compare)

2060 Fairport Nine Mile Point Rd
Suite 400
Penfield, NY 14526-1749
Phone (585) 388-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
407737NYMDPsychiatric/Mental Health Nurse Practitioner
SP033921PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penfield Psychiatry PC Single Specialty CurrentSince Jan 25, 2026 Accepting new patients

Locations

2060 Fairport Nine Mile Point Rd
Ste 400
Penfield, NY 14526
Phone (585) 388-6000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1053284596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CHEMUNG ST",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302735",
            "telephone_number": "607-438-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CHEMUNG ST",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "148302735",
            "telephone_number": "570-250-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ELIZABETH",
        "middle_name": "LACEY",
        "credential": "PSYCH CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407737",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP033921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ROBERTS",
            "credential": "PSYCH CRNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Corning, NY

Sources for this page

Verify at the official NPI Registry.