Individual provider Active NPI

Hermina Barbara Ann Roberts, FNP-BC

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1619361060
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339114-1 Issued in NY
Practice address
1650 Selwyn Ave
10TH Floor
Bronx, NY 10457-7626
Phone
(718) 960-1234
Fax
(718) 960-2055
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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 592943-1 NY
Family Nurse Practitioner 363LF0000X F339114-1 NY Primary

Addresses

Primary practice location

1650 Selwyn Ave
10TH Floor
Bronx, NY 10457-7626

Mailing address

1650 Selwyn Ave
10TH Floor
Bronx, NY 10457-7626
Phone (718) 960-1234

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
592943-1NYMDRegistered Nurse
F339114-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1619361060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 SELWYN AVE",
            "address_2": "10TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577626",
            "telephone_number": "718-960-1234",
            "fax_number": "718-960-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SELWYN AVE",
            "address_2": "10TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577626",
            "telephone_number": "718-960-1234",
            "fax_number": "718-960-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "HERMINA",
        "middle_name": "BARBARA ANN",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "592943-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339114-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.