Individual provider Active NPI

Roberta Loder Patello, LPN

  • Licensed Practical Nurse
  • Belmont, NY
National Provider Identifier
1073664348
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
263867-1 Issued in NY
Practice address
3274 State Route 244
Belmont, NY 14813-9779
Phone
(585) 268-7322
NPI assigned
Jan 15, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 263867-1 NY Primary

Addresses

Primary practice location

3274 State Route 244
Belmont, NY 14813-9779

Mailing address

3274 State Route 244
Belmont, NY 14813-9779
Phone (585) 268-7322

Other identifiers 1

IdentifierTypeStateIssuer
02572705MedicaidNY

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
263867-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073664348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3274 STATE ROUTE 244",
            "city": "BELMONT",
            "state": "NY",
            "postal_code": "148139779",
            "telephone_number": "585-268-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3274 STATE ROUTE 244",
            "city": "BELMONT",
            "state": "NY",
            "postal_code": "148139779",
            "telephone_number": "585-268-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATELLO",
        "first_name": "ROBERTA",
        "middle_name": "LODER",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "263867-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02572705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.