Individual provider Active NPI

Joanna Michele Rose, NP

  • Family Nurse Practitioner
  • Commack, NY
National Provider Identifier
1770167660
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338740-01 Issued in NY
Practice address
353 Veterans Memorial Hwy Ste 104
Commack, NY 11725-4325
Phone
(631) 498-1344
NPI assigned
May 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 F338740-01 NY Primary

Addresses

Primary practice location

353 Veterans Memorial Hwy Ste 104
Commack, NY 11725-4325

Mailing address

276 Woodland Ave
Manorville, NY 11949-2052
Phone (631) 835-6078

Other practice location 1

353 Veterans Memorial Hwy Ste 103
Commack, NY 11725-4325
Phone (631) 498-1344

Other names 1

  • Joanna Michele Hamann Former name

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F338740-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Urology Associates, PC CurrentSince Aug 1, 2021 Accepting new patients

Locations

353 Veterans Memorial Hwy
Ste 103
Commack, NY 11725
Phone (631) 498-1344

353 Veterans Memorial Hwy
Ste 104
Commack, NY 11725
Phone (631) 486-7515

Organizations & group practices 1

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": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1770167660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 WOODLAND AVE",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492052",
            "telephone_number": "631-835-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY STE 104",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254325",
            "telephone_number": "631-498-1344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 Veterans Memorial Hwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117254325",
            "country_code": "US",
            "telephone_number": "631-498-1344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JOANNA",
        "middle_name": "MICHELE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338740-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "HAMANN",
            "middle_name": "MICHELE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.