Individual provider Active NPI

Elizabeth Bridget Rothlauf, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1306145370
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F300992-1 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 427-1540
Fax
(212) 410-7196
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300992-1 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

1 Gustave L Levy PL
Box 3000
New York, NY 10029-6504
Phone (212) 987-3100

Other identifiers 1

IdentifierTypeStateIssuer
02502587MedicaidNY

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
I20170130002225 NY Practitioner - Nurse Practitioner 5799067690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Columbia University College of Physicians and Surgeons, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 731-7822

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300992NYMDLicensed Practical Nurse
F300992-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 13, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 13, 2016 Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1306145370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 3000",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-427-1540",
            "fax_number": "212-410-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHLAUF",
        "first_name": "ELIZABETH",
        "middle_name": "BRIDGET",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300992-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02502587",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.