ROXANE THERESA MONCURE AGNP
NPI 1396202396
Nurse Practitioner - Gerontology in Vicksburg, MS

Q: What is Roxane Moncure's NPI number?

The NPI number for Roxane Moncure is 1396202396. It was assigned to this individual provider in the NPPES registry on February 26, 2019.

Q: What is Roxane Moncure's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Roxane Moncure was last updated on August 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.

Active since February 26, 2019PECOS EnrolledAccepts Medicare Assignment

1911 MISSION 66 STE B, VICKSBURG, MS 39180(601) 456-2598(855) 830-3484 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Roxane Theresa Moncure Agnp NPPES

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

ROXANE THERESA MONCURE AGNP (NPI 1396202396) is an individual gerontology provider in Vicksburg, Mississippi, licensed in Mississippi (AG01190040) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1396202396

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameROXANE THERESA MONCURECredential: AGNP

Location Address1911 MISSION 66 STE BVicksburg, MS 39180-3762

Mailing Address919 Rutherford DrJackson, MS 39206-2033 · (601) 259-6426 · Fax (601) 376-2570

Phone(601) 456-2598

Fax(855) 830-3484

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateFebruary 26, 2019

Last NPPES UpdateAugust 28, 2025

NPPES CertifiedAugust 28, 2025

✔ NPI 1396202396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MS · AG01190040

1911 MISSION 66 STE B, Vicksburg, MS 39180

Open in Google Maps ↗

Other Identifiers 1

Other903127MS · Woundcare

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

Roxane Theresa Moncure Agnp 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 ID8224949433

PECOS Enrollment IDI20191018000052, I20250930000506

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39180 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

Referred Medical Equipment & Supplies CMS DME claims

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

Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6216

DME-Medical/Surgical Supplies · category DA023N

1 supplier18 claims4,410 services$0.04 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 20

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

KAYLA MORIARTY LCSW

Social Worker (Clinical)