Individual provider Active NPI

Lizbeth Rose Rodriguez, NP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1487463493
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354609 Issued in NY
Practice address
23 Regent Cir
Staten Island, NY 10312-1726
Phone
(347) 938-4589
NPI assigned
Jan 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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 354609 NY Primary

Addresses

Primary practice location

23 Regent Cir
Staten Island, NY 10312-1726

Mailing address

23 Regent Cir
Staten Island, NY 10312-1726
Phone (347) 938-4589

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
I20250409003706 NY Practitioner - Nurse Practitioner 8022532159 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
354609NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hicksville Family Medical Care, PLLC CurrentSince Apr 7, 2025 Accepting new patients
Statcare Urgent & Walk in Medical Care PLLC CurrentSince Apr 7, 2025 Accepting new patients

Locations

232 W Old Country Rd
Hicksville, NY 11801
Phone (347) 808-8830

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1487463493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 REGENT CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121726",
            "telephone_number": "347-938-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 REGENT CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121726",
            "telephone_number": "347-938-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LIZBETH",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.