Individual provider Active NPI

Andre Roman, APRN

  • Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1265915052
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.022688 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195
Phone
(800) 223-2273
NPI assigned
Sep 8, 2018
Last updated
Dec 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.022688 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195

Mailing address

9500 Euclid Ave # A40
Cleveland, OH 44195-0001

Other practice location 1

9500 Euclid Ave
Cleveland, OH 44195
Phone (800) 223-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190211000508 OH Practitioner - Nurse Practitioner 4183962582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marymount Hospital IncGroup PAC ID 6507763661, 16 clinicians

Practice addresses (Care Compare)

12300 McCracken Rd
Garfield Heights, OH 44125-2914
Phone (216) 587-8361

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022688OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Nov 27, 2018 Accepting new patients
Marymount Hospital, Inc. Current Accepting new patients
Marymount Hospital Inc CurrentSince Jun 29, 2021 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#A40
Cleveland, OH 44195
Phone (216) 444-2606

12300 McCracken Rd
Garfield Hts, OH 44125
Phone (216) 581-0500

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1265915052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # A40",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44195",
            "telephone_number": "800-223-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "44195",
            "country_code": "US",
            "telephone_number": "800-223-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "ANDRE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-08",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.022688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.