Individual provider Active NPI

Diane Jennifer Rosaly, MS, RN, FNP - C

  • Family Nurse Practitioner
  • Dickinson, TX
National Provider Identifier
1144730573
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135421 Issued in TX
Practice address
676 FM 517 Rd W
Dickinson, TX 77539-3904
Phone
(713) 482-4535
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135421 TX Primary

Addresses

Primary practice location

676 FM 517 Rd W
Dickinson, TX 77539-3904

Mailing address

676 FM 518 W.
Dickinson, TX 77539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20171215000235 TX Practitioner - Nurse Practitioner 8022376383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

646 FM 517 Rd W
Dickinson, TX 77539-3904
Phone (281) 218-7200

676 FM 517 Rd W
Dickinson, TX 77539-3904
Phone (713) 482-4535

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP135421TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Nov 23, 2017 Accepting new patients
St. Elizabeth Physician Group, PLLC CurrentSince May 28, 2019 Accepting new patients
Privia Medical Group Gulf Coast PLLC CurrentSince Nov 23, 2017 Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

676 FM 517 Rd W
Dickinson, TX 77539
Phone (713) 335-9571

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

1009 S Broadway St
La Porte, TX 77571
Phone (281) 471-4202

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: diane.rosaly.1@8042.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1144730573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 FM 518 W.",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "77539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 FM 517 RD W",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775393904",
            "telephone_number": "713-482-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALY",
        "first_name": "DIANE",
        "middle_name": "JENNIFER",
        "credential": "MS, RN, FNP - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, TX

Sources for this page

Verify at the official NPI Registry.