Individual provider Active NPI

Sue Ellen Rose, RN NPC

  • Family Nurse Practitioner
  • Riverdale, NJ
National Provider Identifier
1902064983
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NN07063700 Issued in NJ
Practice address
72 Hamburg Tpke Ste B
Riverdale, NJ 07457-1158
Phone
(973) 696-6687
Fax
(833) 488-1216
NPI assigned
May 27, 2008
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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 26NN07063700 NJ Primary

Addresses

Primary practice location

72 Hamburg Tpke Ste B
Riverdale, NJ 07457-1158

Mailing address

271 Grove Ave Ste E
Verona, NJ 07044-1730
Phone (973) 559-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20140512000383 NJ Practitioner - Nurse Practitioner 6507099819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vanguard Medical Group PAGroup PAC ID 5092751842, 59 clinicians

Practice addresses (Care Compare)

72 Hamburg Tpke
Riverdale, NJ 07457-1160
Phone (973) 696-6687

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vanguard Medical Group, PA CurrentSince Aug 1, 2017 Accepting new patients
Primary Care for the Homebound PA Current Accepting new patients

Locations

700 Route 46 E
Ste 450
Fairfield, NJ 07004
Phone (973) 559-3700

61 Beaverbrook Rd
Ste 301
Lincoln Park, NJ 07035
Phone (973) 686-0420

72 Hamburg Tpke
Riverdale, NJ 07457
Phone (973) 696-6687

72 Hamburg Tpke
Ste B
Riverdale, NJ 07457
Phone (973) 696-6687

271 Grove Ave
Ste A
Verona, NJ 07044
Phone (973) 239-2600

271 Grove Ave
Ste E
Verona, NJ 07044
Phone (973) 559-3700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sue.rose.1@25493.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1902064983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE STE E",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441730",
            "telephone_number": "973-559-3700",
            "fax_number": "833-484-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 HAMBURG TPKE STE B",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571158",
            "telephone_number": "973-696-6687",
            "fax_number": "833-488-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SUE",
        "middle_name": "ELLEN",
        "credential": "RN NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NN07063700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NJ

Sources for this page

Verify at the official NPI Registry.