Active NPI
Lisa H Roselli, MACCCA
- Audiologist
- Shirley, NY
National Provider Identifier
1700992609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 0014931
- Practice address
- 450 William Floyd Pkwy Ste B
Shirley, NY 11967-3480 - Phone
- (516) 617-1599
- NPI assigned
- Aug 22, 2006
- Last updated
- Feb 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 0014931 | NY | Primary |
| Assistive Technology Practitioner Audiologist | 231HA2400X | 0014931 | NY | |
| Audiologist-Hearing Aid Fitter | 237600000X | 0014931 | NY |
Addresses
Primary practice location
450 William Floyd Pkwy Ste B
Shirley, NY 11967-3480
Mailing address
115 Lincoln Rd
Medford, NY 11763-1655
Phone (516) 617-1599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
450 William Floyd Pkwy
Suite B
Shirley, NY 11967-3480
Phone (631) 830-4296
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001493 | NY | MD | Acupuncturist |
| 0014931 | NY | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thunder Hearing Services LLC | Audiologist-Hearing Aid Fitter | Current | Accepting new patients |
| Hearusa Inc | Audiologist-Hearing Aid Fitter | Past | Accepting new patients |
| Advanced Hearing Centers | Audiologist | Past | Accepting new patients |
| Speech Therapy for All PC | Past | Accepting new patients |
Locations
450 William Floyd Pkwy
Ste B
Shirley, NY 11967
Phone (631) 830-4296
Organizations & group practices 4
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.
-
- Audiologist-Hearing Aid Fitter
- Shirley, NY
- NPI 1407387889
-
- Speech-Language Pathologist
- Riverhead, NY
- NPI 1568085439
-
- Audiologist-Hearing Aid Fitter
- West Palm Beach, FL
- NPI 1073560231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1700992609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 LINCOLN RD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117631655",
"telephone_number": "516-617-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 WILLIAM FLOYD PKWY STE B",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119673480",
"telephone_number": "516-617-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSELLI",
"first_name": "LISA",
"middle_name": "H",
"credential": "MACCCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "0014931",
"primary": true
},
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "NY",
"license": "0014931",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "NY",
"license": "0014931",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shirley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.