Individual provider Active NPI

Patricia Rogers, RN, ANP

  • Nurse Practitioner
  • Huntington, NY
National Provider Identifier
1366520603
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
304058 Issued in NY
Practice address
755 New York Ave
Suite 309
Huntington, NY 11743-4240
Phone
(631) 351-1250
Fax
(631) 351-1321
NPI assigned
Nov 2, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 304058 NY Primary

Addresses

Primary practice location

755 New York Ave
Suite 309
Huntington, NY 11743-4240

Mailing address

755 New York Ave
Suite 309
Huntington, NY 11743-4240
Phone (631) 351-1250

Other identifiers 1

IdentifierTypeStateIssuer
304058OtherNYLICENSE

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
304058NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Max Rudansky, MD & Jacques Winter MD, PC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366520603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 NEW YORK AVE",
            "address_2": "SUITE 309",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434240",
            "telephone_number": "631-351-1250",
            "fax_number": "631-351-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 NEW YORK AVE",
            "address_2": "SUITE 309",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434240",
            "telephone_number": "631-351-1250",
            "fax_number": "631-351-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "PATRICIA",
        "credential": "RN, ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "304058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.