Individual provider Active NPI

Carmen Rosa Arroyo, MS/CPNP-PC

  • Pediatric Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1447241534
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382690-1 Issued in NY
Practice address
119 Tompkins Ave
Staten Island, NY 10304-2601
Phone
(917) 485-7752
Fax
(718) 551-0339
NPI assigned
Oct 29, 2005
Last updated
May 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ00068100 NJ
Pediatric Nurse Practitioner 363LP0200X F382690-1 NY Primary

Addresses

Primary practice location

119 Tompkins Ave
Staten Island, NY 10304-2601

Mailing address

119 Tompkins Ave
Staten Island, NY 10304-2601
Phone (917) 485-7752

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
I20210903002343 NY Practitioner - Nurse Practitioner 5799797270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00068100NJMDPediatric Nurse Practitioner
F382690-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA Past Accepting new patients
Hospitalists Emo, LLC Past Accepting new patients
Central Jersey Medical Center, Inc. Past Accepting new patients
Central Jersey Medical Center, Inc Past Accepting new patients

Organizations & group practices 4

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": "1130544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1447241534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 TOMPKINS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042601",
            "telephone_number": "917-485-7752",
            "fax_number": "718-551-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 TOMPKINS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042601",
            "telephone_number": "917-485-7752",
            "fax_number": "718-551-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARROYO",
        "first_name": "CARMEN",
        "middle_name": "ROSA",
        "name_prefix": "Mrs.",
        "credential": "MS/CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-29",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00068100",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382690-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.