Individual provider Active NPI

Leslie A Rosario, RN

  • Critical Care Medicine Registered Nurse
  • Medford, NY
National Provider Identifier
1578899290
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
809149 Issued in NY
Practice address
7 Balsam Dr
Medford, NY 11763-4303
Phone
(631) 627-6368
NPI assigned
Oct 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 809149 NY
Cardiac Rehabilitation Registered Nurse 163WC3500X 809149 NY
Emergency Registered Nurse 163WE0003X 809149 NY
Licensed Practical Nurse 164W00000X 271304 NY
Critical Care Medicine Registered Nurse 163WC0200X 809149 NY Primary

Addresses

Primary practice location

7 Balsam Dr
Medford, NY 11763-4303

Mailing address

7 Balsam Dr
Medford, NY 11763-4303
Phone (631) 627-6368

Other practice location 1

250 Blue Point Ave
Blue Point, NY 11715-1234
Phone (516) 983-3662

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
809149NYMDCritical Care Medicine Registered Nurse
271304NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1578899290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BALSAM DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634303",
            "telephone_number": "631-627-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BALSAM DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634303",
            "telephone_number": "631-627-6368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Blue Point Ave",
            "address_purpose": "LOCATION",
            "city": "Blue Point",
            "state": "NY",
            "postal_code": "117151234",
            "country_code": "US",
            "telephone_number": "516-983-3662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "LESLIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "809149",
            "primary": false
        },
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "NY",
            "license": "809149",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "809149",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "271304",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "809149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.