Individual provider Active NPI

Stephanie Jane Roze I, M.D.

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1891721288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
104480 Issued in NY
Practice address
47 Marcus Garvey Blvd
Brooklyn, NY 11206-5804
Phone
(718) 445-3884
Fax
(718) 453-2628
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 104480 NY Primary

Addresses

Primary practice location

47 Marcus Garvey Blvd
Brooklyn, NY 11206-5804

Mailing address

24037 Depew Ave
Douglaston, NY 11363-1630
Phone (718) 428-1679

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161214001733 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7618257338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891721288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24037 DEPEW AVE",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631630",
            "telephone_number": "718-428-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MARCUS GARVEY BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065804",
            "telephone_number": "718-445-3884",
            "fax_number": "718-453-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZE",
        "first_name": "STEPHANIE",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "104480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.