Lisa Rousso, RD is a medicare enrolled "Dietitian, Registered" provider in South Ozone Park, New York. Her current practice location is
11420 Rockaway Blvd, South Ozone Park, New York. You can reach out to her office (for appointments etc.) via phone at
(646) 229-5575.
Lisa Rousso is licensed to practice in New York (license number 004833) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235385618.
Healthcare Provider's Profile
| Full Name | Lisa Rousso |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 11420 Rockaway Blvd, South Ozone Park, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1235385618
- Provider Enumeration Date: 08/17/2008
- Last Update Date: 10/05/2015
Medicare PECOS Information:
- PECOS PAC ID: 8527007129
- Enrollment ID: I20050502001352
Medical Identifiers
Medical identifiers for Lisa Rousso such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1235385618 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 004833 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Rousso allows following entities to bill medicare on her behalf.
| Provider Name | Ny Diabetes & Endocrinology Care Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1265894943
PECOS PAC ID: 6305145921
Enrollment ID: O20160504001300 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Rousso is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Lisa Rousso, RD
110-11 Queens Blvd #9-d,
Forest Hills, NY 11375-6551
Ph: (646) 229-5575 | Lisa Rousso, RD
11420 Rockaway Blvd,
South Ozone Park, NY 11420-1912
Ph: (646) 229-5575 |
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