Individual provider Active NPI

Sally Roberts, DO

  • Anesthesiology Physician
  • Nyack, NY
National Provider Identifier
1932314036
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
239037 Issued in NY
Practice address
160 N Midland Ave
Nyack Hospital
Nyack, NY 10960-1912
Phone
(845) 348-2862
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 239037 NY Primary

Addresses

Primary practice location

160 N Midland Ave
Nyack Hospital
Nyack, NY 10960-1912

Mailing address

118 N Bedford Rd
Suite 200
Mount Kisco, NY 10549-2553
Phone (914) 666-8866

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
I20090826000317 NY Practitioner - Anesthesiology 3971658022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

160 N Midland Ave
Nyack, NY 10960-1912
Phone (845) 348-2862

195 E Main St
Huntington, NY 11743-2957
Phone (914) 666-8866

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Nov 1, 2017 Accepting new patients
Garden State Sports & Pain Medicine, LLC PastSince Nov 8, 2020 Accepting new patients

Locations

480 Bedford Rd
Ste 4202
Chappaqua, NY 10514
Phone (914) 244-8762

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

118 N Bedford Rd
Ste 200
Mount Kisco, NY 10549
Phone (800) 362-6220

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

974 Route 45
Pomona, NY 10970
Phone (845) 354-1113

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1932314036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N BEDFORD RD",
            "address_2": "SUITE 200",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105492553",
            "telephone_number": "914-666-8866",
            "fax_number": "914-666-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N MIDLAND AVE",
            "address_2": "NYACK HOSPITAL",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601912",
            "telephone_number": "845-348-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SALLY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "239037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

Verify at the official NPI Registry.