MARY ROOF NP
NPI 1639915382
Nurse Practitioner - Acute Care in Jackson, MI

Active since July 02, 2024PECOS EnrolledAccepts Medicare Assignment
205 N EAST AVE, JACKSON, MI 49201(517) 205-4800 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 17, 2024, Jul 2, 2024 (2 updates tracked since 2024).

About Mary Roof Np NPPES

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

MARY ROOF NP (NPI 1639915382) is an individual acute care provider in Jackson, Michigan, licensed in Michigan (4704335747) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Allegiance Health, and maintains a secondary practice location in Jackson.

NPPES Registry Identity

NPI1639915382
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMARY ROOFCredential: NP
Location Address205 N EAST AVEJackson, MI 49201-1753
Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (313) 874-4806
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 2, 2024
Last NPPES UpdateOctober 17, 20242 updates tracked since enumeration
NPPES CertifiedOctober 17, 2024
NPI 1639915382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License Licensed in MI · 4704335747
Also ListedNurse PractitionerTaxonomy 363L00000X · License 4704335747NSA2404U (MI)
205 N EAST AVE, Jackson, MI 49201

Secondary Practice Location 1

Location 11100 E Michigan Ave Ste 201Jackson, MI 49201 · Phone (517) 205-3345

Accepted 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

Mary Roof Np 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 ID42743494
PECOS Enrollment IDI20241024000754
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.

Hospital Affiliations CMS Care Compare

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

Henry Ford Allegiance Health

Acute Care Hospitals · Jackson, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230092
Location205 N East AveJackson, MI 49201 · Jackson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49201 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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 20

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

Emergency Medicine
205 N EAST AVE
JACKSON, MI 49201
Nurse Anesthetist, Certified Registered
205 N EAST AVE
JACKSON, MI 49201
Psychiatry & Neurology (Psychiatry)
205 N EAST AVE
JACKSON, MI 49201
Emergency Medicine
205 N EAST AVE
JACKSON, MI 49201
Internal Medicine (Pulmonary Disease)
205 N EAST AVE
JACKSON, MI 49201
Emergency Medicine
205 N EAST AVE
JACKSON, MI 49201
Emergency Medicine
205 N EAST AVE
JACKSON, MI 49201
Emergency Medicine
205 N EAST AVE
JACKSON, MI 49201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639915382, enumerated as an "individual" on July 02, 2024.

The provider is located at 205 N EAST AVE JACKSON, MI 49201 and the phone number is (517) 205-4800.

Nurse Practitioner with taxonomy code 363LA2100X and a focus in Acute Care.

The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.

Mary Roof is affiliated with: HENRY FORD ALLEGIANCE HEALTH.