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DR. SAMI A ROUMANI M.D.
NPI 1306936414
Family Medicine in Milwaukee, WI

Active since October 13, 2006PECOS EnrolledAccepts Medicare Assignment
75.75/100
CMS Quality Rating
3046 S 13TH ST, MILWAUKEE, WI 53215(414) 649-9696(414) 649-9698 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Sami A Roumani M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMI A ROUMANI M.D. (NPI 1306936414) is an individual family medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (34275) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, and is a graduate of Other (1978).

NPPES Registry Identity

NPI1306936414
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SAMI A ROUMANICredential: M.D.
Location Address3046 S 13TH STMilwaukee, WI 53215-3826
Mailing Address3046 S 13th StMilwaukee, WI 53215-3826 · (414) 649-9696 · Fax (414) 649-9698
Phone(414) 649-9696
Fax(414) 649-9698
Sole ProprietorYes
Medical School CMSOtherGraduated 1978
Enumeration DateOctober 13, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1306936414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 34275
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3046 S 13TH ST, Milwaukee, WI 53215
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Other Identifiers 3

Medicaid31947200WI
Other391817459012WI · Blue Cross Blue Sheild
Medicare UPINF63532WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sami A Roumani M.d. 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.

PECOS PAC ID1658340021
PECOS Enrollment IDI20100201000015
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
110 services21 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
74 services69 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
12 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Columbia St Mary's Hospital Milwaukee

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520051
Location2323 N Lake DrMilwaukee, WI 53211 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53215 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.16
Promoting Interoperability76
Improvement Activities40
Cost57.63

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Insertion tray without drainage bag and without catheter (accessories only) A4310
DME-Medical/Surgical Supplies · category DA000N
1 supplier12 claims12 services$7.47 avg. paid by Medicare
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
1 supplier13 claims13 services$24.41 avg. paid by Medicare
Urinary catheter anchoring device, leg strap, each A4334
DME-Orthotic Devices · category DF000N
1 supplier12 claims12 services$4.76 avg. paid by Medicare
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4338
DME-Orthotic Devices · category DF000N
1 supplier12 claims12 services$11.86 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
2 suppliers25 claims37 services$9.39 avg. paid by Medicare
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
1 supplier11 claims110 services$4.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHABBAR SAJJAD MD SC
Internal Medicine
3046 S 13TH ST
MILWAUKEE, WI 53215
Milwaukee County (414) 649-9696
SHABBAR SAJJAD MD
Internal Medicine
3046 S 13TH ST
MILWAUKEE, WI 53215
Milwaukee County (414) 649-9696

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 Sami Roumani's NPI number?

The NPI number for Sami Roumani is 1306936414. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Sami Roumani located?

Sami Roumani practices at 3046 S 13th St, Milwaukee, WI 53215. The listed phone number is (414) 649-9696.

What is Sami Roumani's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sami Roumani enrolled in Medicare?

Yes. Sami Roumani 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.

What insurance does Sami Roumani accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Sami Roumani as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sami Roumani affiliated with any hospitals?

According to CMS data, Sami Roumani is affiliated with Ascension Columbia St Mary's Hospital Milwaukee.

When was this NPI record last updated?

The NPPES record for Sami Roumani was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.