Individual provider Active NPI

Nicole A Rouhana, FNP

  • Family Nurse Practitioner
  • Vestal, NY
National Provider Identifier
1295833598
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333072 Issued in NY
Practice address
4417 Vestal Pkwy E
Breast Center
Vestal, NY 13850-3556
Phone
(607) 240-2885
Fax
(607) 240-2886
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 000176 NY
Family Nurse Practitioner 363LF0000X 333072 NY Primary

Addresses

Primary practice location

4417 Vestal Pkwy E
Breast Center
Vestal, NY 13850-3556

Mailing address

346 Grand Ave
Johnson City, NY 13790-2558
Phone (607) 240-2885

Other names 1

  • Nicole A Rouhana Other name

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
I20131009002202 NY Practitioner - Nurse Practitioner 3072747849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Binghamton Obstetrics and Gynecology,PLLCGroup PAC ID 6800933870, 3 clinicians

Practice addresses (Care Compare)

365 Harry L Dr
Suite 110
Johnson City, NY 13790-1471
Phone (607) 729-5805

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394
  • Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
000176NYMDAcupuncturist
333072NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Binghamton Obstetrics and Gynecology,PLLC CurrentSince Jul 1, 2016 Accepting new patients
United Medical Associates PC Past Accepting new patients
Family Planning of South Central New York, Inc. PastSince May 26, 2018 Accepting new patients

Locations

365 Harry L Dr
Ste 110
Johnson City, NY 13790
Phone (607) 729-5805

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6285/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nicole.rouhana@greaterbinghamtonobgyn.chartmakerdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1295833598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902558",
            "telephone_number": "607-240-2885",
            "fax_number": "607-240-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PKWY E",
            "address_2": "BREAST CENTER",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-240-2885",
            "fax_number": "607-240-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUHANA",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "000176",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ROUHANA",
            "middle_name": "A",
            "credential": "PHD; CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.