Individual provider Active NPI

Rose Emeline Cesaire, FNP

  • Family Nurse Practitioner
  • Smithtown, NY
National Provider Identifier
1720538143
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009297 Issued in NC
Practice address
373 Route 111 Ste 14
Smithtown, NY 11787-4759
Phone
(631) 265-7577
Fax
(631) 265-0204
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009297 NC Primary

Addresses

Primary practice location

373 Route 111 Ste 14
Smithtown, NY 11787-4759

Mailing address

PO Box 249
373 Route 111, Suite 14
Smithtown, NY 11787-0249
Phone (631) 265-7577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170501000572 NC Practitioner - Nurse Practitioner 7618254632
I20180113000027 NY Practitioner - Nurse Practitioner 7618254632

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340502NYMDSurgery Physician
5009297NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BRMG-PC Family Medicine CurrentSince Mar 15, 2017 Accepting new patients
Optum Urgent Care, PLLC Past Accepting new patients

Locations

640 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 526-7997

905 Rockford St
Mount Airy, NC 27030
Phone (336) 719-2440

Interoperability endpoints

  • Direct secure messaging: rlawrence521598@direct.medicine.duke.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1720538143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "address_2": "373 ROUTE 111, SUITE 14",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117870249",
            "telephone_number": "631-265-7577",
            "fax_number": "631-265-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 ROUTE 111 STE 14",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874759",
            "telephone_number": "631-265-7577",
            "fax_number": "631-265-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CESAIRE",
        "first_name": "ROSE",
        "middle_name": "EMELINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.