Individual provider Active NPI

Melissa Roman, APRN-BC

  • Family Nurse Practitioner
  • Novi, MI
National Provider Identifier
1922178797
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704221433 Issued in MI
Practice address
39450 W 12 Mile Rd FL 2
Novi, MI 48377-3600
Phone
(313) 916-7359
Fax
(313) 916-9027
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 4704221433 MI Primary

Addresses

Primary practice location

39450 W 12 Mile Rd FL 2
Novi, MI 48377-3600

Mailing address

22024 Knudsen Dr
Grosse Ile, MI 48138-1395
Phone (313) 916-7359

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mroman1@direct.hfhs.org
Direct Messaging Address mroman1@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040706000987 MI Practitioner - Nurse Practitioner 6608853809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-6688

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704221433MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Family CurrentSince Mar 23, 2010 Accepting new patients
Henry Ford Health System CurrentSince Mar 23, 2010 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3031 W Grand Blvd
Ste 800
Detroit, MI 48202
Phone (313) 916-2151

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

39450 W Twelve Mile Rd
Fl 2
Novi, MI 48377
Phone (313) 916-7359

Interoperability endpoints

  • Direct secure messaging: mroman15601@direct.hfhs.org

Organizations & group practices 2

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.

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922178797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22024 KNUDSEN DR",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481381395",
            "telephone_number": "313-916-7359",
            "fax_number": "313-916-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39450 W 12 MILE RD FL 2",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773600",
            "telephone_number": "313-916-7359",
            "fax_number": "313-916-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "MELISSA",
        "credential": "APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704221433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroman1@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "39450 W 12 Mile Rd",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483773600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroman1@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "39450 W 12 Mile Rd Fl 2",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483773600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.