Individual provider Active NPI

Roberta Ann Grant, FNP C

  • Nurse Practitioner
  • Horseheads, NY
National Provider Identifier
1548358203
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F3347761 Issued in NY
Practice address
100 John Roemmelt Dr Ste 204
Horseheads, NY 14845-8304
Phone
(607) 795-2828
Fax
(607) 795-2829
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F3347761 NY Primary

Addresses

Primary practice location

100 John Roemmelt Dr Ste 204
Horseheads, NY 14845-8304

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050

Other identifiers 1

IdentifierTypeStateIssuer
02850613MedicaidNY

Other names 1

  • Miss Roberta Ann Donald Former name

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
I20070723000337 NY Practitioner - Nurse Practitioner 5991806804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians

Practice addresses (Care Compare)

100 John Roemmelt Dr
Suite 301
Horseheads, NY 14845-8304
Phone (607) 739-0352

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
46.76
Promoting interoperability
100
Improvement activities
40
Cost
77.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F3347761NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Medical Services PLLC CurrentSince Jan 1, 2014 Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients

Locations

555 Saint Josephs Blvd
Elmira, NY 14901
Phone (607) 733-6541

571 Saint Josephs Blvd
Ste 304
Elmira, NY 14901
Phone (607) 271-2050

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

571 Saint Josephs Blvd
Fl 2
Elmira, NY 14901
Phone (607) 271-2050

600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161

100 John Roemmelt Dr
Ste 204
Horseheads, NY 14845
Phone (607) 795-2828

100 John Roemmelt Dr
Ste 301
Horseheads, NY 14845
Phone (607) 739-0352

418 S Hamilton St
#109A
Painted Post, NY 14870
Phone (607) 936-2089

Interoperability endpoints

  • Direct secure messaging: roberta.grant@arn.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1548358203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JOHN ROEMMELT DR STE 204",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458304",
            "telephone_number": "607-795-2828",
            "fax_number": "607-795-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F3347761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02850613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERTA",
            "last_name": "DONALD",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.