Individual provider Active NPI

Nichole Lynn Rockowitz, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Southold, NY
National Provider Identifier
1689834525
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309222 Issued in NY
Practice address
57190 Route 25
Southold, NY 11971
Phone
(631) 765-3620
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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 309222 NY Primary

Addresses

Primary practice location

57190 Route 25
Southold, NY 11971

Mailing address

57190 Route 25
Southold, NY 11971-4750
Phone (631) 765-3620

Other practice location 1

57190 Route 25
Southold, NY 11971
Phone (631) 765-3620

Other identifiers 1

IdentifierTypeStateIssuer
1689834525MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190731002593 NY Practitioner - Nurse Practitioner 3577899327 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 18, 2024 Accepting new patients
Mehri Songhorian MD PC CurrentSince Sep 20, 2022 Accepting new patients
New York University CurrentSince Aug 18, 2024 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Oct 23, 2023 Accepting new patients
North Fork House Calls, LLC PastSince Jul 18, 2019 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

Interoperability endpoints

  • Direct secure messaging: nrockowitz505540@nyumc.direct-ci.com

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 2

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1689834525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57190 ROUTE 25",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119714750",
            "telephone_number": "631-765-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57190 ROUTE 25",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "11971",
            "telephone_number": "631-765-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57190 Route 25",
            "address_purpose": "LOCATION",
            "city": "Southold",
            "state": "NY",
            "postal_code": "11971",
            "country_code": "US",
            "telephone_number": "631-765-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKOWITZ",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689834525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southold, NY

Sources for this page

Verify at the official NPI Registry.