Individual provider Active NPI

Christian Routh, MSN, AGNP-C

  • Adult Health Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1467960294
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308297 Issued in NY
Practice address
Vascular Surgery HSC T19-090
Stony Brook, NY 11794-8191
Phone
(631) 444-2037
NPI assigned
Jan 15, 2018
Last updated
Jan 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308297 NY Primary

Addresses

Primary practice location

Vascular Surgery HSC T19-090
Stony Brook, NY 11794-8191

Mailing address

155 Division Ave
West Sayville, NY 11796-1313

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
I20180409001987 NY Practitioner - Nurse Practitioner 6901169713 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
308297NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Mar 15, 2018 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: christian.routh@direct.stonybrookmedicine.edu

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, 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": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1467960294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 DIVISION AVE",
            "city": "WEST SAYVILLE",
            "state": "NY",
            "postal_code": "117961313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VASCULAR SURGERY HSC T19-090",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948191",
            "telephone_number": "631-444-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUTH",
        "first_name": "CHRISTIAN",
        "credential": "MSN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.