Rose Mary Jibin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F351200 Issued in NY

Practice address

450 Lakeville Rd
New Hyde Park, NY 11042-1118

Phone

(516) 734-8000

NPI assigned

Nov 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rosemaryjibin@nslijmedgr.allscriptsdirect.net

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1467228429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 RIBBON ST",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110104304",
            "telephone_number": "917-215-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421118",
            "telephone_number": "516-734-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIBIN",
        "first_name": "ROSE MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.