Individual provider Active NPI

Roseann Mignone, PA

  • Medical Physician Assistant
  • New Hyde Park, NY
National Provider Identifier
1972623460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
009590 Issued in NY
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1433
Phone
(516) 465-1900
Fax
(516) 465-1830
NPI assigned
Mar 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Medical Physician Assistant 363AM0700X 009590 NY Primary

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1433

Mailing address

175 Community Dr
Great Neck, NY 11021-5502
Phone (516) 465-1900

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
I20110104000075 NY Practitioner - Physician Assistant 6103014386 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 5, 2015 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

300 Community Dr
Manhasset, NY 11030

27005 76th Ave
North New Hyde Pk, NY 11040

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: rmignone218522@northwell.direct-ci.com
  • Direct secure messaging: roseannmignone@nslijmedgr.allscriptsdirect.net

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972623460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 COMMUNITY DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215502",
            "telephone_number": "516-465-1900",
            "fax_number": "516-465-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401433",
            "telephone_number": "516-465-1900",
            "fax_number": "516-465-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIGNONE",
        "first_name": "ROSEANN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "009590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.