MR. JONATHAN ROMAN NURSE PRACTITIONER
NPI 1164896874
Nurse Practitioner - Psychiatric/Mental Health in Corona, NY
About Mr. Jonathan Roman Nurse Practitioner NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JONATHAN ROMAN NURSE PRACTITIONER (NPI 1164896874) is an individual psychiatric/mental health provider in Corona, New York, licensed in New York (F404462-01) and active in the NPI registry since November 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Jonathan Roman Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jonathan Roman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Elmhurst, NY 11373
- Reassigned Medicare billing, New York enrollment
- 50 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 11368 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Jonathan Roman's NPI number?
The NPI number for Jonathan Roman is 1164896874. It was assigned to this individual provider in the NPPES registry on November 18, 2015.
Where is Jonathan Roman located?
Jonathan Roman practices at 10467 44th Ave Apt 2, Corona, NY 11368. The listed phone number is (917) 569-6742.
What is Jonathan Roman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jonathan Roman enrolled in Medicare?
Yes. Jonathan Roman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jonathan Roman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Roman reassigns Medicare benefits to Long Island Consultation Center, Inc. (Elmhurst, NY). 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 Jonathan Roman'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 Jonathan Roman was last updated on November 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mr. Jonathan Roman, NURSE PRACTITIONER · NPI 1164896874
Psychiatric/Mental Health physician in Corona, New York. Individual provider, active in the CMS NPPES registry since November 18, 2015.
## Identity
- **NPI:** 1164896874 (Entity type: Individual)
- **Enumerated:** November 18, 2015
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** F404462-01 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10467 44TH AVE APT 2, Corona, NY 11368-2597
- **Phone:** (917) 569-6742
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Long Island Consultation Center, Inc. (NPI 1295878577, Elmhurst, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** November 21, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1164896874) · Data from the CMS NPPES public registry.