Individual provider Active NPI

Jessica Rogala, LPN, RN

  • Licensed Practical Nurse
  • Syracuse, NY
National Provider Identifier
1568707693
Registry record updated Oct 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
277166 Issued in NY
Practice address
136 Hancock Dr
Syracuse, NY 13207-1545
Phone
(315) 664-3639
NPI assigned
Nov 29, 2012
Last updated
Oct 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X N63058 NY
Licensed Practical Nurse 164W00000X 277166 NY Primary

Addresses

Primary practice location

136 Hancock Dr
Syracuse, NY 13207-1545

Mailing address

136 Hancock Dr
Syracuse, NY 13207-1545
Phone (315) 664-3639

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL M
CONNECT URL Idk

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
277166NYMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790985600000",
    "number": "1568707693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 HANCOCK DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132071545",
            "telephone_number": "315-664-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 HANCOCK DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132071545",
            "telephone_number": "315-664-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGALA",
        "first_name": "JESSICA",
        "credential": "LPN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2026-10-03",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "N63058",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "277166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "M",
            "affiliation": "N",
            "address_1": "136 Hancock Dr",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132071545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Idk",
            "affiliation": "N",
            "address_1": "136 Hancock Dr",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132071545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2026; 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.