Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1093231177 Deactivated / Inactive NPI Female Practitioner

Sandra Marie Roller , LPN

Licensed Practical Nurse • Newburgh, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Sandra Roller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 21, 2017
NPI Deactivation Date August 19, 2024
Total Practice Duration ~7 Years of Practice (2017 – 2024)

Professional Overview & Biography Verified Profile Summary

Sandra Roller, LPN was a registered Licensed Practical Nurse practicing in Newburgh, NY. Throughout an active medical career spanning 7 years, Sandra Roller provided care at the practice location at 90 POWDER MILL RD until profile deactivation on 2024-08-19.

Practice Location & Contact Primary Location

Practice Address

90 Powder Mill Rd

Newburgh, NY 125502655

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Newburgh, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.0 Yrs
Regional Practice Density
68 Specialists

Practicing in Newburgh, NY (23738 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License NJ 26NP06092200

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated August 19, 2024

Record deactivated on August 19, 2024

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Licensed Practical Nurse (License #26NP06092200 in NJ)

NPI Profile Active August 21, 2017

NPI status registered as active in NPPES database

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Updated Practice Location August 21, 2017

Registered at 90 POWDER MILL RD, NEWBURGH, NY 125502655 (Tel: (609) 634-6086)

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Updated Business Mailing Address August 21, 2017

Registered at 90 POWDER MILL RD, NEWBURGH, NY 125502655 (Tel: 6096346086)

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Provider Name / Credentials Updated August 21, 2017

Recorded as SANDRA ROLLER, LPN

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 21, 2017

Licensed Practical Nurse (License #26NP06092200 in NJ)

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Initial NPI Registration & Enumeration August 21, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1093231177
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 21, 2017
Last Update: August 21, 2017
Deactivation Date: August 19, 2024

Mailing Address

90 Powder Mill Rd

Newburgh, NY 125502655

Phone: 6096346086

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.