Individual provider Active NPI

Stephanie Angela Van Rossem

  • Women's Health Nurse Practitioner
  • Astoria, NY
National Provider Identifier
1497301444
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
421399 Issued in NY
Practice address
28-18 Astoria Blvd, Astoria, Ny 11102
Astoria, NY 11102
Phone
(917) 410-6905
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 421399 NY Primary

Addresses

Primary practice location

28-18 Astoria Blvd, Astoria, Ny 11102
Astoria, NY 11102

Mailing address

9901 164TH Ave
Howard Beach, NY 11414-4009
Phone (718) 551-4588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
421399NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Walk in GYN Care, PC CurrentSince Jul 1, 2020 Accepting new patients
Walk in Womens Gynecology PLLC PastSince Aug 18, 2019 Accepting new patients

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1497301444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 164TH AVE",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114144009",
            "telephone_number": "718-551-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28-18 ASTORIA BLVD, ASTORIA, NY 11102",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "917-410-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ROSSEM",
        "first_name": "STEPHANIE",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.