Individual provider Active NPI

Marc Joseph Romano, PSYD, PMHNP, BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilton Manors, FL
National Provider Identifier
1245312180
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9205122 Issued in FL
Practice address
2145 NE 5TH Ave
Wilton Manors, FL 33305-1157
Phone
(954) 296-9464
Fax
(954) 820-5533
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5846 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9205122 FL Primary

Addresses

Primary practice location

2145 NE 5TH Ave
Wilton Manors, FL 33305-1157

Mailing address

2145 NE 5TH Ave
Wilton Manors, FL 33305-1157
Phone (954) 296-9464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141021000805 FL Practitioner - Nurse Practitioner 4789619925 Reassigns benefits to 1 organization
I20220302002333 WI Practitioner - Nurse Practitioner 4789619925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32211
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5846FLMDClinical Psychologist
ARNP9205122FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Evizzit of Iowa Psychiatry PC PastSince Dec 26, 2021 Accepting new patients
Brightside Medical, P.C. Past Accepting new patients
Marc J. Romano, Arnp, PA Psychiatric/Mental Health PastSince May 5, 2014 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

6501 Arlington Expy
Ste B105
Jacksonville, FL 32211
Phone (904) 302-9355

1375 Maple Tree Pl
Williston, VT 05495
Phone (802) 327-7788

Organizations & group practices 5

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1245312180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 NE 5TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051157",
            "telephone_number": "954-296-9464",
            "fax_number": "954-206-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 NE 5TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051157",
            "telephone_number": "954-296-9464",
            "fax_number": "954-820-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANO",
        "first_name": "MARC",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PSYD, PMHNP, BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "5846",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9205122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

Verify at the official NPI Registry.