Individual provider Active NPI

Virginia Elizabeth Robertson, MD

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1548348782
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
187576 Issued in NY
Practice address
726 Broadway
NYU SHC Room 405
New York, NY 10003
Phone
(122) 443-1000
Fax
(212) 443-1002
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 187576 NY Primary

Addresses

Primary practice location

726 Broadway
NYU SHC Room 405
New York, NY 10003

Mailing address

175 Willoughby St Apt 16H
Brooklyn, NY 11201-5411
Phone (718) 451-6032

Other identifiers 1

IdentifierTypeStateIssuer
01516898MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
187576NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brownsville Community Development Corporation CurrentSince Dec 7, 2025 Accepting new patients
Lichfpp Physicians Family Medicine Past Accepting new patients

Locations

592 Rockaway Ave
Brooklyn, NY 11212
Phone (718) 345-5000

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1548348782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 WILLOUGHBY ST APT 16H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015411",
            "telephone_number": "718-451-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 BROADWAY",
            "address_2": "NYU SHC ROOM 405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "122-443-1000",
            "fax_number": "212-443-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "VIRGINIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "187576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01516898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.