Active NPI
Rose Mesidor
- Pediatrics Physician
- Bellerose, NY
National Provider Identifier
1265568661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 212910
- Practice address
- 7403 Commonwealth Blvd
Bellerose, NY 11426-1839 - Phone
- (718) 464-2900
- NPI assigned
- Feb 27, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 212910 | NY | Primary |
Addresses
Primary practice location
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Mailing address
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 212910 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160318001943 | NY | Order and Referring Only - Pediatric Medicine | 5799082772 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265568661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7403 COMMONWEALTH BLVD",
"city": "BELLEROSE",
"state": "NY",
"postal_code": "114261839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7403 COMMONWEALTH BLVD",
"city": "BELLEROSE",
"state": "NY",
"postal_code": "114261839",
"telephone_number": "718-464-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESIDOR",
"first_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "212910",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212910",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellerose, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.