Individual provider Active NPI

Rebekah Roberts, FNP

  • Family Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1790356269
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F347104 Issued in NY
Practice address
325 Mamaroneck Ave
White Plains, NY 10605-1440
Phone
(914) 287-7650
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 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 F347104 NY Primary

Addresses

Primary practice location

325 Mamaroneck Ave
White Plains, NY 10605-1440

Mailing address

18 Washington Mews
Port Chester, NY 10573-3946
Phone (914) 255-2808

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
I20220107000851 NY Practitioner - Nurse Practitioner 5991196677 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patriot Medical Wound Health PCGroup PAC ID 4385090794, 7 clinicians
Patriot MedicalGroup PAC ID 3870927197, 15 clinicians

Practice addresses (Care Compare)

2817 Albany Post Rd
Montgomery, NY 12549-2132
Phone (845) 421-3155

787 King St
Port Chester, NY 10573-1225
Phone (800) 750-8616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F347104NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Medical CurrentSince May 2, 2025 Accepting new patients
Patriot Medical Wound Health PC CurrentSince May 2, 2025 Accepting new patients
Patriot Medical Nyc PC CurrentSince May 2, 2025 Accepting new patients

Locations

96 Linwood Plz
Fort Lee, NJ 07024
Phone (201) 681-5066

4499 Manhattan College Pkwy
Bronx, NY 10471
Phone (718) 548-5100

2817 Albany Post Rd
Montgomery, NY 12549
Phone (484) 680-1355

787 King St
Rye Brook, NY 10573
Phone (914) 600-7149

Organizations & group practices 3

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1790356269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WASHINGTON MEWS",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733946",
            "telephone_number": "914-255-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAMARONECK AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051440",
            "telephone_number": "914-287-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "REBEKAH",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F347104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.