Individual provider Active NPI

Susanne Roberts, R.N., N.P.C.

  • Women's Health Nurse Practitioner
  • West Long Branch, NJ
National Provider Identifier
1083640957
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NN07628400 Issued in NJ
Practice address
1019 Broadway
West Long Branch, NJ 07764-1326
Phone
(732) 229-6797
Fax
(732) 229-6893
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 26NN07628400 NJ Primary

Addresses

Primary practice location

1019 Broadway
West Long Branch, NJ 07764-1326

Mailing address

2208 Alpine TRL
Neptune, NJ 07753-4469
Phone (732) 774-2607

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NN07628400NJMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Comprehensive Health Care of New Jersey PastSince Aug 22, 2016 Accepting new patients
Lifeline Medical Associates, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083640957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 ALPINE TRL",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534469",
            "telephone_number": "732-774-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 BROADWAY",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641326",
            "telephone_number": "732-229-6797",
            "fax_number": "732-229-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SUSANNE",
        "name_prefix": "Ms.",
        "credential": "R.N., N.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NN07628400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.