Individual provider Active NPI

Madeline Rosario, LPN

  • Licensed Practical Nurse
  • Patchogue, NY
National Provider Identifier
1417568957
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
285635-1 Issued in NY
Practice address
73 Swezey St Apt 1
Patchogue, NY 11772-4163
Phone
(631) 394-6739
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 285635-1 NY Primary

Addresses

Primary practice location

73 Swezey St Apt 1
Patchogue, NY 11772-4163

Mailing address

73 Swezey St
Patchogue, NY 11772-4163
Phone (631) 394-6739

Other identifiers 1

IdentifierTypeStateIssuer
2113MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 73swezeystpatchogueny11772 Health Information Exchange (HIE)

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

State licenses

LicenseStateTypeSpecialty
285635-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1417568957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 SWEZEY ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724163",
            "telephone_number": "631-394-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 SWEZEY ST APT 1",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724163",
            "telephone_number": "631-394-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "MADELINE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "285635-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2113",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "73swezeystpatchogueny11772",
            "affiliation": "N",
            "endpointDescription": "Home",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Home",
            "address_1": "73 Swezey St Apt 1",
            "city": "Patchogue",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117724163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.