Active NPI
Delores Maria Roberts, LPN
- Licensed Practical Nurse
- New York, NY
National Provider Identifier
1194434928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 242491
- Practice address
- 200 Varick St RM 900
New York, NY 10014-4893 - Phone
- (212) 620-0340
- NPI assigned
- Nov 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 242491 | NY | Primary |
Addresses
Primary practice location
200 Varick St RM 900
New York, NY 10014-4893
Mailing address
200 Varick St RM 900
New York, NY 10014-4893
Phone (212) 620-0340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123456789 | Medicaid | NY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | delores.roberts@projectrenewal.org | ||
| Direct Messaging Address | delores.roberts@projectrenewal.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242491 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1194434928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 VARICK ST RM 900",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100144893",
"telephone_number": "212-620-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 VARICK ST RM 900",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100144893",
"telephone_number": "212-620-0340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DELORES",
"middle_name": "MARIA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-21",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "242491",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123456789",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "delores.roberts@projectrenewal.org",
"affiliation": "N",
"address_1": "200 Varick St Rm 900",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100144893",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "delores.roberts@projectrenewal.org",
"affiliation": "N",
"address_1": "200 Varick St Rm 900",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100144893",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.