Individual provider Active NPI

Sherise Warner Rollock

  • Family Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1417475864
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341332-1 Issued in NY
Practice address
8900 Van Wyck Expressway
Jamaica, NY 11418
Phone
(718) 206-6000
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 F341332-1 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expressway
Jamaica, NY 11418

Mailing address

8900 Van Wyck Expy
Jamaica, NY 11418-2832
Phone (718) 206-6000

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
I20180201001109 NY Practitioner - Nurse Practitioner 2860752383 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F341332-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Nov 7, 2017 Accepting new patients
Jamaica Hospital CurrentSince Nov 7, 2017 Accepting new patients

Locations

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Ste 2
Richmond Hill, NY 11418
Phone (718) 206-7001

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417475864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182832",
            "telephone_number": "718-206-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPRESSWAY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "718-206-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER ROLLOCK",
        "first_name": "SHERISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341332-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.