Individual provider Active NPI

Elizabeth Marie Rooney

  • Family Nurse Practitioner
  • Sparkill, NY
National Provider Identifier
1174011241
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340165 Issued in NY
Practice address
12 Van Ter
Sparkill, NY 10976-1406
Phone
(845) 642-2090
NPI assigned
Apr 24, 2018
Last updated
Apr 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 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 340165 NY Primary

Addresses

Primary practice location

12 Van Ter
Sparkill, NY 10976-1406

Mailing address

12 Van Ter
Sparkill, NY 10976-1406
Phone (845) 642-2090

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260209001218 CT Practitioner - Nurse Practitioner 4486133667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12 Van Ter
Sparkill, NY 10976-1406

424 Church St
Nashville, TN 37219-2301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11056CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Jan 1, 2026 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1224 Mill St
Bldg B
East Berlin, CT 06023
Phone (860) 406-4894

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1174011241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 VAN TER",
            "city": "SPARKILL",
            "state": "NY",
            "postal_code": "109761406",
            "telephone_number": "845-642-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 VAN TER",
            "city": "SPARKILL",
            "state": "NY",
            "postal_code": "109761406",
            "telephone_number": "845-642-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONEY",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparkill, NY

Sources for this page

Verify at the official NPI Registry.