Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Roses

Individual provider Behavior Analyst · NPI 1962070995

Kelly Roses is a Physician Assistant in Staten Island, New York. Qualified in 2023, 3 years ago. Practices with Hackensack Meridian Health Medical Group - Specialty Care PC, a 1,897-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

96 Edgegrove Ave
Staten Island, NY 10312-3312
Phone: (718) 696-7717
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7000 Austin St Ste 200, Forest Hills, NY 11375-4739 — (718) 762-7633

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Behavior Analyst Taxonomy 103K00000X · Licence 1364201191 (NY)
Specialist Taxonomy 174400000X

Record details

NPI number1962070995
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 15, 2021
Last updated in NPPESApril 18, 2023
Certification dateApril 18, 2023
Mailing address96 Edgegrove Ave, Staten Island, NY 10312-3312

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Hackensack Meridian Health Medical Group - Specialty Care Pc — 1897 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Staten Island