Individual provider Active NPI

Roseline Louis Felisma

  • Physical Therapy Assistant
  • Elizabeth, NJ
National Provider Identifier
1508605312
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00404200 Issued in NJ
Practice address
734 N Broad St Apt T1
Elizabeth, NJ 07208-2333
Phone
(561) 814-9237
NPI assigned
May 21, 2024
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00404200 NJ Primary

Addresses

Primary practice location

734 N Broad St Apt T1
Elizabeth, NJ 07208-2333

Mailing address

734 N Broad St Apt T1734
Elizabeth, NJ 07208-2312
Phone (561) 814-9237

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
40QB00404200NJMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1508605312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N BROAD ST APT T1734",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082312",
            "telephone_number": "561-814-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 N BROAD ST APT T1",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082333",
            "telephone_number": "561-814-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS FELISMA",
        "first_name": "ROSELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00404200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.