Roosevelet PT PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ROOSEVELET PT PC

Practice address

591 W Merrick Rd
Valley Stream, NY 11580-5119

Phone

(516) 206-0100

Fax

(516) 206-0101

NPI assigned

Feb 24, 2025

Organization subpart

No

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

Authorized official

Name

Amro Barakat

Title

PT

Phone

(631) 318-3148

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Mann, MS, RD, CSR

  • Renal Nutrition Registered Dietitian
  • Fort Lauderdale, FL
  • NPI 1669039285
  NPD

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1215733829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WINHAM AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064930",
            "telephone_number": "631-318-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 W MERRICK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805119",
            "telephone_number": "516-206-0100",
            "fax_number": "516-206-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELET PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "BARAKAT",
        "authorized_official_first_name": "AMRO",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "631-318-3148"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Rae Roeda, PA-C
• Victor Joseph Roger, LCSW
• John C Rohe, MD
• John Rojas, R.N.
• Christopher Michael Rooney
• Melissa Rosado
• Emmanuel J Rosales, M.A., L.C.S.W.
• Rosedale Mind Care Psychiatry PC
• Sam Rosen, LMSW
• Michele Rosenblum, AU.D

• Clinic/Center in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.