Individual provider Active NPI

Rolla Nuoman

  • Neurology with Special Qualifications in Child Neurology Physician
  • Sleepy Hollow, NY
National Provider Identifier
1457770620
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
275710 Issued in NY
Practice address
755 N Broadway Ste 540
Sleepy Hollow, NY 10591
Phone
(914) 358-0188
Fax
(914) 358-0189
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 275710 NY Primary

Addresses

Primary practice location

755 N Broadway Ste 540
Sleepy Hollow, NY 10591

Mailing address

149 King St Apt 3
Chappaqua, NY 10514-3458
Phone (508) 847-6687

Other practice location 1

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7000

Other practice location 2

755 N Broadway Ste 540
Sleepy Hollow, NY 10591
Phone (914) 358-0188

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190404001278 NY Practitioner - Pediatric MedicinePractitioner - Neurology 3971844796 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
275710NYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Apr 1, 2019 Accepting new patients
Boston Children'S Health Physicians, LLP CurrentSince Apr 1, 2019 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

40 Saw Mill River Rd
Hawthorne, NY 10532
Phone (914) 345-8888

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

755 N Broadway
Ste 540
Sleepy Hollow, NY 10591
Phone (914) 358-0188

100 Woods Rd
#O
Valhalla, NY 10595

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

40 Sunshine Cottage Rd
#1
Valhalla, NY 10595
Phone (914) 493-1524

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: rolla.nuoman.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 3

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1457770620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 KING ST APT 3",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105143458",
            "telephone_number": "508-847-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N BROADWAY STE 540",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "10591",
            "telephone_number": "914-358-0188",
            "fax_number": "914-358-0189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 N Broadway Ste 540",
            "address_purpose": "LOCATION",
            "city": "Sleepy Hollow",
            "state": "NY",
            "postal_code": "10591",
            "country_code": "US",
            "telephone_number": "914-358-0188",
            "fax_number": "914-358-0189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUOMAN",
        "first_name": "ROLLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "275710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.