Individual provider Active NPI

Susan Marie Rosato

  • Family Nurse Practitioner
  • Cincinnatus, NY
National Provider Identifier
1215341128
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338796 Issued in NY
Practice address
2805 Cincinnatus Road
Cincinnatus, NY 13040-0000
Phone
(607) 863-4126
Fax
(607) 863-3455
NPI assigned
Jun 18, 2014
Last updated
Feb 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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 338796 NY Primary

Addresses

Primary practice location

2805 Cincinnatus Road
Cincinnatus, NY 13040-0000

Mailing address

17 Main St
Suite 302
Cortland, NY 13045-6606
Phone (607) 753-3797

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161219002090 NY Practitioner - Nurse Practitioner 9335461722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
338796NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Dec 12, 2016 Accepting new patients
MVHS Inc CurrentSince Dec 12, 2016 Accepting new patients
Family Health Network of Central New York, Inc. Past Accepting new patients
Deruyter Health Center Past Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

Interoperability endpoints

  • Direct secure messaging: srosato13594@mvhealthsystem.direct-ci.com

Organizations & group practices 4

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1215341128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MAIN ST",
            "address_2": "SUITE 302",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130456606",
            "telephone_number": "607-753-3797",
            "fax_number": "607-753-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 CINCINNATUS ROAD",
            "city": "CINCINNATUS",
            "state": "NY",
            "postal_code": "130400000",
            "telephone_number": "607-863-4126",
            "fax_number": "607-863-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSATO",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnatus, NY

Sources for this page

Verify at the official NPI Registry.