Individual provider Active NPI

Marie Ludy Roc, RN

  • Registered Nurse
  • Elmont, NY
National Provider Identifier
1811171556
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
6650469 Issued in NY
Practice address
1629 Woodstock St
Elmont, NY 11003-4442
Phone
(516) 633-3887
NPI assigned
Dec 18, 2007
Last updated
Apr 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 6650469 NY Primary

Addresses

Primary practice location

1629 Woodstock St
Elmont, NY 11003-4442

Mailing address

1629 Woodstock St
Elmont, NY 11003-4442
Phone (516) 568-0411

Other identifiers 1

IdentifierTypeStateIssuer
01542112MedicaidNY

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
6650469NYMDRegistered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1811171556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 WOODSTOCK ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034442",
            "telephone_number": "516-568-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 WOODSTOCK ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034442",
            "telephone_number": "516-633-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROC",
        "first_name": "MARIE",
        "middle_name": "LUDY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "6650469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01542112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.