Individual provider Active NPI

Roseann Stashin, ANP

  • Adult Health Nurse Practitioner
  • Lindenhurst, NY
National Provider Identifier
1841496346
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F302314 Issued in NY
Practice address
290 S Wellwood Ave
Lindenhurst, NY 11757-4903
Phone
(631) 225-2999
Fax
(631) 225-2104
NPI assigned
Jun 22, 2007
Last updated
Jan 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F302314 NY Primary

Addresses

Primary practice location

290 S Wellwood Ave
Lindenhurst, NY 11757-4903

Mailing address

290 S Wellwood Ave
Lindenhurst, NY 11757-4903
Phone (631) 225-2999

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
I20140619001027 NY Order and Referring Only - Nurse Practitioner 3173747839

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F302314NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Long Island Medical Group, P.C. Past Accepting new patients

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1841496346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 S WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574903",
            "telephone_number": "631-225-2999",
            "fax_number": "631-225-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117574903",
            "telephone_number": "631-225-2999",
            "fax_number": "631-225-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASHIN",
        "first_name": "ROSEANN",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F302314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.