Samantha Roche, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

401987 Issued in NY

Practice address

167 Broadway
Amityville, NY 11701-2782

Phone

(631) 317-9480

Fax

(231) 216-7467

NPI assigned

Sep 12, 2014

Last updated

Jul 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Shore Collaborative Psychiatry NP PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Amityville, NY
  • NPI 1942882246
  Medicare reassignment NPD Authorized official
• South Shore Mental Health Counseling Services,PC

  • Professional Counselor
  • East Islip, NY
  • NPI 1366890949
  NPD (past)

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1609277268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012782",
            "telephone_number": "631-317-9480",
            "fax_number": "231-216-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012782",
            "telephone_number": "631-317-9480",
            "fax_number": "231-216-7467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Carleton Ave",
            "address_purpose": "LOCATION",
            "city": "East Islip",
            "state": "NY",
            "postal_code": "117301222",
            "country_code": "US",
            "telephone_number": "631-317-9480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "SAMANTHA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Maria Rivera, LMSW
• Tiffany Rivera
• Amiya Gabrielle Roberts
• Andrea Elizabeth Roberts, L.P.N.
• Rachel Louise Robles, LMHC
• Linda Rohan, DNP, APRN-BC
• Linda Rollins
• Jennifer Roman, LMSW
• Zuraitza Sayuri Romero
• Yue Rong, LMT, LAC

• Psychiatric/Mental Health Nurse Practitioner in Amityville, NY
• Providers in Amityville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.