Individual provider Active NPI

Roechelle Montenegro, NP

  • Family Nurse Practitioner
  • Sea Cliff, NY
National Provider Identifier
1487330437
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352243 Issued in NY
Practice address
207 Glen Cove Avenue
Sea Cliff, NY 11579
Phone
(516) 676-1742
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 352243 NY Primary

Addresses

Primary practice location

207 Glen Cove Avenue
Sea Cliff, NY 11579

Mailing address

218-11 Spencer Avenue
Queens Village, NY 11427

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
I20240307003842 NY Practitioner - Nurse Practitioner 7911343348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

911 Park Ave
Apt 1B
New York, NY 10075-0385
Phone (212) 288-7193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
352243NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Family Practice Medical PC CurrentSince Dec 31, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEDDAA/Endpoint/EEDDAA

Organizations & group practices 1

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": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1487330437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218-11 SPENCER AVENUE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 GLEN COVE AVENUE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "11579",
            "telephone_number": "516-676-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "ROECHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sea Cliff, NY

Sources for this page

Verify at the official NPI Registry.