Active NPI
Roam Healthcare Inc - a Professional Nursing Corporation
- Family Nurse Practitioner
- Northridge, CA
National Provider Identifier
1063920296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95005617
- Legal business name
- ROAM HEALTHCARE INC - A PROFESSIONAL NURSING CORPORATION
- Practice address
- 8345 Reseda Blvd Ste 209
Northridge, CA 91324-5941 - Phone
- (818) 433-0262
- Fax
- (818) 979-7206
- NPI assigned
- Jan 23, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Joy Porciuncula, NP
- Title
- President
- Phone
- (818) 433-0262
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95005617 | CA | Primary |
Addresses
Primary practice location
8345 Reseda Blvd Ste 209
Northridge, CA 91324-5941
Mailing address
8345 Reseda Blvd Ste 209
Northridge, CA 91324-5941
Phone (747) 224-7994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180327000379 | CA | Part B Supplier - Clinic/Group Practice | 1052673357 |
Receives reassigned benefits from 4 practitioners Practice locations: Northridge, CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Addiction Medicine (Family Medicine) Physician
- Los Angeles, CA
- NPI 1659394633
CA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516665600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718064000000",
"number": "1063920296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8345 RESEDA BLVD STE 209",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913245941",
"telephone_number": "747-224-7994",
"fax_number": "818-979-7206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8345 RESEDA BLVD STE 209",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913245941",
"telephone_number": "818-433-0262",
"fax_number": "818-979-7206"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROAM HEALTHCARE INC - A PROFESSIONAL NURSING CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-23",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A",
"authorized_official_last_name": "PORCIUNCULA",
"authorized_official_first_name": "MICHELLE JOY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-433-0262",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95005617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.