Individual provider Active NPI

Melissa Rozakis, CNS

  • Clinical Nurse Specialist
  • Dallas, TX
National Provider Identifier
1053643726
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
AP127091 Issued in TX
Practice address
12228 N Central Expy Ste 410
Dallas, TX 75243-3797
Phone
(214) 265-5050
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 765767 TX
Clinical Nurse Specialist 364S00000X AP127091 TX Primary

Addresses

Primary practice location

12228 N Central Expy Ste 410
Dallas, TX 75243-3797

Mailing address

8440 Walnut Hill LN
Suite 250
Dallas, TX 75231-3833
Phone (214) 265-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150422001471 TX Practitioner - Certified Clinical Nurse Specialist (CNS) 4880912989 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
765767TXMDRegistered Nurse First Assistant
AP127091TXMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wfo Group LLC CurrentSince Jan 5, 2022 Accepting new patients

Locations

7777 Forest Ln
Ste C106
Dallas, TX 75230
Phone (214) 823-7090

3500 Gaston Ave
Dallas, TX 75246

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1053643726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8440 WALNUT HILL LN",
            "address_2": "SUITE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752313833",
            "telephone_number": "214-265-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12228 N CENTRAL EXPY STE 410",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433797",
            "telephone_number": "214-265-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZAKIS",
        "first_name": "MELISSA",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "765767",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "AP127091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.