JENNIFER J ROAN FNP
NPI 1629891452
Nurse Practitioner - Family in Phoenix, AZ

Q: What is Jennifer Roan's NPI number?

The NPI number for Jennifer Roan is 1629891452. It was assigned to this individual provider in the NPPES registry on October 31, 2024.

Q: What is Jennifer Roan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Roan was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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 October 31, 2024PECOS EnrolledAccepts Medicare Assignment

4742 E INDIAN SCHOOL RD, PHOENIX, AZ 85018(480) 598-6776(602) 954-2145 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Jennifer J Roan Fnp NPPES

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

JENNIFER J ROAN FNP (NPI 1629891452) is an individual family provider in Phoenix, Arizona, licensed in Arizona (313948) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1629891452

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJENNIFER J ROANCredential: FNP

Location Address4742 E INDIAN SCHOOL RDPhoenix, AZ 85018-5496

Mailing Address4742 E Indian School RdPhoenix, AZ 85018-5496 · (206) 940-1016

Phone(480) 598-6776

Fax(602) 954-2145

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateOctober 31, 2024

Last NPPES UpdateDecember 4, 2024

NPPES CertifiedDecember 4, 2024

✔ NPI 1629891452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LF0000X

License✔ Licensed in AZ · 313948

4742 E INDIAN SCHOOL RD, Phoenix, AZ 85018

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

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

Jennifer J Roan Fnp 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 ID2264968361

PECOS Enrollment IDI20241212003204

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.

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Roan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Minuteclinic LLC

1,969 mi

Family

7955 TUCKERMAN LN
Rockville, MD 20854

Reassigned Medicare billing, Arizona enrollment
163 clinicians in this Medicare group

NPI 1134191836 (866) 389-2727

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 85018 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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.

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.

SANDRA JOLY

Pharmacist