Semone Sabrina Roach, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

004767 Issued in CT

Practice address

1162 New Britain Ave
West Hartford, CT 06110-2410

Phone

(860) 236-3084

Fax

(860) 561-5961

NPI assigned

Oct 10, 2011

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: semone.roach.1@27673.direct.athenahealth.com

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.

• Collins Medical Associates 2 PC

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1912928169

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1114201118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102410",
            "telephone_number": "860-236-3084",
            "fax_number": "860-561-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102410",
            "telephone_number": "860-236-3084",
            "fax_number": "860-561-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "SEMONE",
        "middle_name": "SABRINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "004767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD-UNITED HEALTHCARE",
            "identifier": "P4428347",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008034903",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sroach16868@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Saint Francis Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1162 New Britain Ave",
            "city": "West Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061102410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rene R Rivard, LO, FCLSA(H)
• Kristine Stickney Rivera, LCSW
• Naida Rivera, CAC
• Nadia Rivkin, LCSW
• John D. Rixon, M.D.
• Robert L. Cercietto, M.D., P.C.
• Robert Szczepanski, Psychotherapist
• Robin M. Gilmartin, LCSW, LLC
• Braedon Robinson
• Tracey Anne Robinson, M.A., LPC

• Pediatric Nurse Practitioner in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.