Jessica Romano

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404413 Issued in NY

Practice address

400 Horseblock Rd Ste H
Farmingville, NY 11738-1252

Phone

(631) 233-9490

NPI assigned

Aug 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 19, 2022 through Oct 19, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: statpsych.jessicaromano@145385.advancedmd-direct.com

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1356061659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HORSEBLOCK RD STE H",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HORSEBLOCK RD STE H",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381252",
            "telephone_number": "631-233-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON MEDICARE AND NON MEDICAID PROVIDER",
            "identifier": "404413",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara E Robertson
• Rachel Roger, LCSW
• J'Mar Romain, LPN,EMT
• Jennifer Ann Romain, LPN, EMT
• Jenine Romano, SLP-CCC
• Michelle J Romano, RN
• Maureen Romeo-Gallagher
• Niccole Rosa
• Yolette Rousseau-Amy, R.N.
• Stephanie Rued, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Farmingville, NY
• Providers in Farmingville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.