Individual provider Active NPI

Roodelyne Petit-Homme

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1780416578
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11034871 Issued in FL
Practice address
11190 Health Park Blvd
Naples, FL 34110-5729
Phone
(239) 624-5000
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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 APRN11034871 FL Primary

Addresses

Primary practice location

11190 Health Park Blvd
Naples, FL 34110-5729

Mailing address

16401 NW 37TH Ave
Miami Gardens, FL 33054-6313

Other practice location 1

16401 NW 37th Ave
Miami Gardens, FL 33054-6313
Phone (786) 693-3805

Other practice location 2

350 7th St N
Naples, FL 34102-5754
Phone (239) 624-3997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241218000427 FL Practitioner - Nurse Practitioner 5395272199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

11190 Health Park Blvd
Naples, FL 34110-5729
Phone (239) 552-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11034871FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd Inc CurrentSince Feb 18, 2025 Accepting new patients
Nchmd, Inc CurrentSince Feb 18, 2025 Accepting new patients
Yadah Alf LLC Current Accepting new patients
At Home MD CurrentSince Nov 18, 2024 Accepting new patients

Locations

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

2338 Immokalee Rd
Naples, FL 34110
Phone (239) 330-2933

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

Interoperability endpoints

  • Direct secure messaging: rpetithommeandre21194@nchhealthcaresystem.direct-ci.com

Organizations & group practices 4

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1780416578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16401 NW 37TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 HEALTH PARK BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105729",
            "telephone_number": "239-624-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16401 NW 37th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330546313",
            "country_code": "US",
            "telephone_number": "786-693-3805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 7th St N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025754",
            "country_code": "US",
            "telephone_number": "239-624-3997",
            "fax_number": "239-624-8101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETIT-HOMME",
        "first_name": "ROODELYNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11034871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.