Individual provider Active NPI

Jennifer Renee Roman, APRN

  • Family Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1033824487
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11023964 Issued in FL
Practice address
1925 Mizell Ave Ste 201
Winter Park, FL 32792-4155
Phone
(407) 646-7015
NPI assigned
Jan 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 11023964 FL
Family Nurse Practitioner 363LF0000X APRN11023964 FL Primary

Addresses

Primary practice location

1925 Mizell Ave Ste 201
Winter Park, FL 32792-4155

Mailing address

1925 Mizell Ave Ste 201
Winter Park, FL 32792-4155
Phone (407) 646-7015

Other practice location 1

685 Palm Springs Dr Ste 2A
Altamonte Springs, FL 32701-7896
Phone (407) 830-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230223000720 FL Practitioner - Nurse Practitioner 4385017268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1925 Mizell Ave
Winter Park, FL 32792-4155

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11023964FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Feb 12, 2024 Accepting new patients
Orlando Immunology Center PA Infectious Disease CurrentSince Jan 1, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 12, 2024 Accepting new patients

Locations

685 Palm Springs Dr
Ste 2A
Altamonte Springs, FL 32701
Phone (407) 830-5577

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1925 Mizell Ave
Ste 201
Winter Park, FL 32792
Phone (407) 303-7399

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jroman1262341@adventhealth.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1033824487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE STE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924155",
            "telephone_number": "407-646-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE STE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924155",
            "telephone_number": "407-646-7015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "685 Palm Springs Dr Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327017896",
            "country_code": "US",
            "telephone_number": "407-830-5577",
            "fax_number": "407-830-4164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "11023964",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.