Individual provider Active NPI

Kindred Marie Corsame Eluna Roszell, ARNP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1861967887
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
357356 Issued in NY
Practice address
30 Broad St FL 45
New York, NY 10004-2942
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Oct 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN9284945 FL
Nurse Practitioner 363L00000X 357356 NY Primary

Addresses

Primary practice location

30 Broad St FL 45
New York, NY 10004-2942

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9800

Other practice location 2

13340 Metro Pkwy Ste 1000
Fort Myers, FL 33966-4819
Phone (239) 343-0490

Other identifiers 1

IdentifierTypeStateIssuer
101316400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelunaroszell120184@Direct.leememorial.org Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, 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
I20181206003219 FL Practitioner - Nurse Practitioner 7517201213 Reassigns benefits to 4 organizations
I20260501001341 NY Practitioner - Nurse Practitioner 7517201213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians
Chaim Gitelis DO PCGroup PAC ID 6507090396, 18 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

333 W 41St St
Suite 414
Miami Beach, FL 33140-3608
Phone (212) 734-6621

3501 Health Ctr Blvd
Estero, FL 34135-8127

4751 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9888

4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9800

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
357356NYMDNurse Practitioner
RN9284945FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Nurse Practitioner CurrentSince Nov 12, 2018 Accepting new patients
Millennium Physician Group LLC CurrentSince Feb 26, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Feb 26, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Chaim Gitelis DO PC CurrentSince Jan 24, 2026 Accepting new patients
Lee Memorial Health System CurrentSince Nov 12, 2018 Accepting new patients
Lee Health System Inc Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients

Locations

9500 Bonita Beach Rd SE
Ste 101
Bonita Springs, FL 34135
Phone (239) 498-9294

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343

4771 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9800

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kelunaroszell120184@direct.leememorial.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1861967887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST FL 45",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042942",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4771 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339071317",
            "country_code": "US",
            "telephone_number": "239-343-9800",
            "fax_number": "239-343-9848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13340 Metro Pkwy Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339664819",
            "country_code": "US",
            "telephone_number": "239-343-0490",
            "fax_number": "239-343-0499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELUNA ROSZELL",
        "first_name": "KINDRED",
        "middle_name": "MARIE CORSAME",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9284945",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "357356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101316400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelunaroszell120184@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.