Individual provider Active NPI

Marie Elizabeth Roantree, FNP-BC

  • Family Nurse Practitioner
  • Roslyn, NY
National Provider Identifier
1306609060
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352184 Issued in NY
Practice address
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone
(516) 562-6000
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 352184 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd
Roslyn, NY 11576-1347

Mailing address

49 Buckram Rd
Locust Valley, NY 11560-1927
Phone (609) 634-8396

Other practice location 1

101 Saint Andrews Ln
Glen Cove, NY 11542-2254
Phone (516) 674-7300

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
I20240425001436 NY Practitioner - Nurse Practitioner 6800236704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

321 Crossways Park Dr
Woodbury, NY 11797-2066
Phone (516) 734-8500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Services, P.C. CurrentSince Mar 10, 2024 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

300 Community Dr
Plandome, NY 11030

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

415 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 838-8400

321 Crossways Park Dr
Ste B
Woodbury, NY 11797
Phone (631) 470-1450

321 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 405-7100

40 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 496-3900

Networks

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

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1306609060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BUCKRAM RD",
            "city": "LOCUST VALLEY",
            "state": "NY",
            "postal_code": "115601927",
            "telephone_number": "609-634-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "516-562-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Saint Andrews Ln",
            "address_purpose": "LOCATION",
            "city": "Glen Cove",
            "state": "NY",
            "postal_code": "115422254",
            "country_code": "US",
            "telephone_number": "516-674-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROANTREE",
        "first_name": "MARIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.