Individual provider Active NPI

Ronald E. Roseo

  • Licensed Practical Nurse
  • Bay Shore, NY
National Provider Identifier
1053955617
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
3346671 Issued in NY
Practice address
33 W Garfield St
Bay Shore, NY 11706-7205
Phone
(631) 220-2800
NPI assigned
Nov 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 3346671 NY Primary

Addresses

Primary practice location

33 W Garfield St
Bay Shore, NY 11706-7205

Mailing address

33 W Garfield St
Bay Shore, NY 11706-7205
Phone (631) 220-2800

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
3346671NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1053955617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W GARFIELD ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067205",
            "telephone_number": "631-220-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W GARFIELD ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067205",
            "telephone_number": "631-220-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEO",
        "first_name": "RONALD",
        "middle_name": "E.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "3346671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.