Amy L Roberts, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014615-1 Issued in NY

Practice address

627 Broadway
Suite 1
Massapequa, NY 11758-5031

Phone

(516) 308-4040

Fax

(516) 804-6386

NPI assigned

Apr 19, 2011

Last updated

Mar 29, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Sisselman Medical Group, PC

  • Internal Medicine Physician
  • Massapequa, NY
  • NPI 1851572358
  Medicare reassignment
• PJS Medical Diagnostic PLLC

  • Diagnostic Radiology Physician
  • Port Jefferson Station, NY
  • NPI 1609110295
  NPD (past)

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1083904494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "SUITE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-308-4040",
            "fax_number": "516-804-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "SUITE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-308-4040",
            "fax_number": "516-804-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014615-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverhead Medical & Rehabilitation PC
• David G Robbins, DPM
• Robert McKee PT, PLLC
• Robert Mucciolo MD PC
• Robert Ruppert Mental Health Counseling PLLC
• Rockville Centre Massage Therapy, PC
• Marietta Rodriguez, MS ED.
• Chelsea Rodriquez, FNP
• Victoria Leigh Roger, LCSW
• Stephen E Rogers, DMD

• Physician Assistant in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.