Active NPI
Rosie M. Malcolm, NP
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1073794053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F334798
- Practice address
- 1 Penn PLZ
7TH Floor, Suite 725
New York, NY 10119-0002 - Phone
- (800) 842-2478
- NPI assigned
- Nov 19, 2007
- Last updated
- May 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F334798 | NY | Primary |
| Registered Nurse | 163W00000X | 435456 | NY |
Addresses
Primary practice location
1 Penn PLZ
7TH Floor, Suite 725
New York, NY 10119-0002
Mailing address
21 Ann St
New City, NY 10956-2945
Phone (914) 708-6918
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02941817 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F334798 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Avenue Medical Associates, P.C. | Past | Accepting new patients | |
| Optum Care Services Company | Family | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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-
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- Columbia, MD
- NPI 1912199415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401408000000",
"number": "1073794053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 ANN ST",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109562945",
"telephone_number": "914-708-6918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PENN PLZ",
"address_2": "7TH FLOOR, SUITE 725",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101190002",
"telephone_number": "800-842-2478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALCOLM",
"first_name": "ROSIE",
"middle_name": "M.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-19",
"last_updated": "2014-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F334798",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "435456",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02941817",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.