Individual provider Active NPI

Theresa Fitzgerald Rattazzi, RN,BSN,MS,FNP

  • Family Nurse Practitioner
  • Monroe, NY
National Provider Identifier
1417265018
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336482 Issued in NY
Practice address
505 State Route 208
Monroe, NY 10950-1608
Phone
(845) 783-6699
Fax
(845) 783-7641
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 336482 NY Primary
Family Nurse Practitioner 363LF0000X 26NJ00314400 NJ

Addresses

Primary practice location

505 State Route 208
Monroe, NY 10950-1608

Mailing address

505 State Route 208
Monroe, NY 10950-1608
Phone (845) 783-6699

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
I20231226000718 NY Practitioner - Nurse Practitioner 6305014176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Arc Healthresources of Rockland, Inc. CurrentSince Oct 22, 2023 Accepting new patients

Locations

70 Phillips Hill Rd
New City, NY 10956
Phone (845) 267-0110

210 Route 303
Vly Cottage, NY 10989
Phone (845) 267-0110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1417265018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 STATE ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501608",
            "telephone_number": "845-783-6699",
            "fax_number": "845-783-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 STATE ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501608",
            "telephone_number": "845-783-6699",
            "fax_number": "845-783-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATTAZZI",
        "first_name": "THERESA",
        "middle_name": "FITZGERALD",
        "name_prefix": "Mrs.",
        "credential": "RN,BSN,MS,FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336482",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00314400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.