Individual provider Active NPI

Susan M Roberti, MS, DNP, RN, FNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1336415835
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337169 Issued in NY
Practice address
1200 Waters PL
Suite M105
Bronx, NY 10461-2728
Phone
(718) 892-7033
Fax
(718) 892-0736
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 337169 NY Primary

Addresses

Primary practice location

1200 Waters PL
Suite M105
Bronx, NY 10461-2728

Mailing address

1200 Waters PL
Suite M105
Bronx, NY 10461-2728
Phone (718) 892-7033

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
Credentials
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
337169NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1336415835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WATERS PL",
            "address_2": "SUITE M105",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612728",
            "telephone_number": "718-892-7033",
            "fax_number": "718-892-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WATERS PL",
            "address_2": "SUITE M105",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612728",
            "telephone_number": "718-892-7033",
            "fax_number": "718-892-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTI",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MS, DNP, RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.