Individual provider Active NPI

Janet Leslie Roen, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1649221425
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
134794 Issued in NY
Practice address
220 Madison Ave
New York, NY 10016-3422
Phone
(212) 679-8885
Fax
(212) 683-3915
NPI assigned
May 15, 2006
Last updated
Feb 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 134794 NY Primary

Addresses

Primary practice location

220 Madison Ave
New York, NY 10016-3422

Mailing address

220 Madison Ave
New York, NY 10016-3422
Phone (212) 679-8885

Other identifiers 1

IdentifierTypeStateIssuer
00690729MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
134794NYMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1649221425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163422",
            "telephone_number": "212-679-8885",
            "fax_number": "212-683-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163422",
            "telephone_number": "212-679-8885",
            "fax_number": "212-683-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEN",
        "first_name": "JANET",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "134794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00690729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.