JANE PRISCILLA ROACH CRNP
NPI 1063559292
Nurse Practitioner - Pediatrics in Crofton, MD
About Jane Priscilla Roach Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JANE PRISCILLA ROACH CRNP (NPI 1063559292) is an individual pediatrics provider in Crofton, Maryland, licensed in Maryland (R066995) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jane Priscilla Roach Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jane Roach reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gambrills, MD 21054
- Reassigned Medicare billing, Maryland and District of Columbia enrollments
- Also billed through NPI 1114728060 (District of Columbia)
- 794 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CROFTON, MD 21114
CROFTON, MD 21114
CROFTON, MD 21114
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jane Roach's NPI number?
The NPI number for Jane Roach is 1063559292. It was assigned to this individual provider in the NPPES registry on January 30, 2007.
Where is Jane Roach located?
Jane Roach practices at 2191 Defense Hwy Suite 201, Crofton, MD 21114. The listed phone number is (410) 451-9091.
What is Jane Roach's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Jane Roach enrolled in Medicare?
Yes. Jane Roach is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jane Roach's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jane Roach reassigns Medicare benefits to Luminis Health Medical Group, LLC (Gambrills, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jane Roach's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jane Roach was last updated on February 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jane Priscilla Roach, CRNP · NPI 1063559292
Pediatrics physician in Crofton, Maryland. Individual provider, active in the CMS NPPES registry since January 30, 2007.
## Identity
- **NPI:** 1063559292 (Entity type: Individual)
- **Enumerated:** January 30, 2007
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** R066995 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 2191 DEFENSE HWY, SUITE 201, Crofton, MD 21114-2931
- **Phone:** (410) 451-9091 · **Fax:** (410) 451-9094
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Luminis Health Medical Group, LLC (NPI 1508995697, Gambrills, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 7, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1063559292) · Data from the CMS NPPES public registry.