Individual provider Active NPI

Natalie Nicole Roman, FNP-C

  • Family Nurse Practitioner
  • Lake Jackson, TX
National Provider Identifier
1629545462
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139503 Issued in TX
Practice address
190 Abner Jackson Pkwy Ste 220
Lake Jackson, TX 77566-5170
Phone
(979) 549-1218
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139503 TX Primary

Addresses

Primary practice location

190 Abner Jackson Pkwy Ste 220
Lake Jackson, TX 77566-5170

Mailing address

190 Abner Jackson Pkwy Ste 200
Lake Jackson, TX 77566-5169
Phone (979) 529-2520

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
I20191219000637 TX Practitioner - Nurse Practitioner 4385078674 Reassigns benefits to 1 organization

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
Elite Healthcare Services, PLLCGroup PAC ID 4789099029, 2 clinicians

Practice addresses (Care Compare)

190 Abner Jackson Pkwy
Suite 200
Lake Jackson, TX 77566-5171
Phone (979) 529-2520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP139503TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Healthcare Services, PLLC CurrentSince Feb 1, 2021 Accepting new patients

Locations

190 Abner Jackson Pkwy
Ste 200
Lake Jackson, TX 77566
Phone (979) 529-2500

190 Abner Jackson Pkwy
Ste 220
Lake Jackson, TX 77566
Phone (979) 549-1218

Interoperability endpoints

  • Direct secure messaging: natalie.roman.1@23761.direct.athenahealth.com

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, 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": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1629545462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ABNER JACKSON PKWY STE 200",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665169",
            "telephone_number": "979-529-2520",
            "fax_number": "979-529-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ABNER JACKSON PKWY STE 220",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665170",
            "telephone_number": "979-549-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "NATALIE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.