NPIMap

Individual provider Active NPI

Roshini Mylakkattu Paul, ANP

  • Adult Health Nurse Practitioner
  • Dix Hills, NY
National Provider Identifier
1649418062
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
304801 Issued in NY
Practice address
7 Weaver LN
Dix Hills, NY 11746-5018
Phone
(631) 459-9500
NPI assigned
Jan 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 304801 NY Primary

Addresses

Primary practice location

7 Weaver LN
Dix Hills, NY 11746-5018

Mailing address

7 Weaver LN
Dix Hills, NY 11746-5018
Phone (631) 459-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722000131 NY Practitioner - Nurse Practitioner 1456575588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Bishai MD, LLCGroup PAC ID 1153693254, 9 clinicians
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

5 Beach Rd
Massapequa, NY 11758-6614
Phone (516) 550-9865

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Hauppauge, NY, CCN 337232
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
67.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
304801NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients
Maimonides Medical Center Current Accepting new patients
Michael Bishai MD, LLC CurrentSince Mar 10, 2020 Accepting new patients
Samaritan Medical Services, P.C. CurrentSince Oct 1, 2016 Accepting new patients
Thomas Physical Therapy PC CurrentSince Feb 18, 2024 Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: roshini.kurian@direct.stonybrookmedicine.edu
  • Direct secure messaging: roshinikurian@mai.allscriptsdirect.net

Organizations & group practices 5

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

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1649418062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WEAVER LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465018",
            "telephone_number": "631-459-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WEAVER LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465018",
            "telephone_number": "631-459-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "ROSHINI",
        "middle_name": "MYLAKKATTU",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.