Individual provider Active NPI

Lisa Rolon, MD

  • Obstetrics & Gynecology Physician
  • Greenlawn, NY
National Provider Identifier
1174703193
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
242572 Issued in NY
Practice address
284 Pulaski Rd
Greenlawn, NY 11740-1602
Phone
(631) 425-5245
Fax
(631) 425-0140
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 242572 NY Primary

Addresses

Primary practice location

284 Pulaski Rd
Greenlawn, NY 11740-1602

Mailing address

284 Pulaski Rd
Greenlawn, NY 11740-1602
Phone (631) 425-5245

Other identifiers 1

IdentifierTypeStateIssuer
02962527MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080521000820 NY Practitioner - Obstetrics/Gynecology 3072682616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of Ny Upstate Medical University, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Huntington Hospital Dolan Family Health CenterGroup PAC ID 1153211792, 9 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1572 New York Ave
Huntington Station, NY 11746-2418
Phone (631) 425-5250

270 Park Ave
Suite 1
Huntington, NY 11743-2787
Phone (631) 351-2219

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
242572NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwell Health Current Accepting new patients
North Shore-Lij Medical PC Obstetrics & Gynecology CurrentSince May 7, 2017 Accepting new patients
Huntington Hospital Dolan Family Health Center CurrentSince Mar 19, 2012 Accepting new patients
Brookdale Family Care Center, Inc. Obstetrics & Gynecology Past Accepting new patients
Huntington Hospital Association Past Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

284 Pulaski Rd
Greenlawn, NY 11740
Phone (631) 425-5250

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

270 Park Ave
Fl 1
Huntington, NY 11743
Phone (631) 351-2219

1572 New York Ave
Huntington Station, NY 11746
Phone (631) 425-5250

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: lrolon67481@northwell.direct-ci.com
  • Direct secure messaging: lisarolon@northwell.allscriptsdirect.net

Organizations & group practices 6

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 1

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1174703193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 PULASKI RD",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401602",
            "telephone_number": "631-425-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 PULASKI RD",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401602",
            "telephone_number": "631-425-5245",
            "fax_number": "631-425-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLON",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "242572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02962527",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenlawn, NY

Sources for this page

Verify at the official NPI Registry.