Active NPI
Roxanne Eagan, LMSW
- Social Worker
- Middletown, NY
National Provider Identifier
1235448051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 054159-1
- Practice address
- 379 Mt Hope Rd
Middletown, NY 10940-7135 - Phone
- (845) 344-2292
- Fax
- (845) 342-2054
- NPI assigned
- Sep 28, 2010
- Last updated
- Sep 28, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 054159-1 | NY | Primary |
Addresses
Primary practice location
379 Mt Hope Rd
Middletown, NY 10940-7135
Mailing address
379 Mt Hope Rd
Middletown, NY 10940-7135
Phone (845) 344-2292
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 |
|---|---|---|---|
| 054159-1 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nysarc | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Middletown, NY
- NPI 1558631929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285632000000",
"number": "1235448051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "379 MT HOPE RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109407135",
"telephone_number": "845-344-2292",
"fax_number": "845-342-2054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "379 MT HOPE RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109407135",
"telephone_number": "845-344-2292",
"fax_number": "845-342-2054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGAN",
"first_name": "ROXANNE",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-28",
"last_updated": "2010-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "054159-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, NY
- Catherine P Duryea, LCSW
- Patricia Duvleavy
- Calvin Dymond, RPA-C
- Dynamic Center, Inc
- Debra Lynne Dziedzic, AUD, CCC-A, FAAA
- Thomas Eanelli, M.D.
- East Main Street Chemists Inc (Neighborx Pharmacy at Ormc)
- East Main Street Chemists Inc (Neighborx Pharmacy at Ormc)
- Louise Helena Eaton, FNP
- Toni Ann Eaton, RPA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.