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

Q: What is Mary Roof's NPI number?

The NPI number for Mary Roof is 1639915382. It was assigned to this individual provider in the NPPES registry on July 2, 2024.

Q: What is Mary Roof's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Mary Roof was last updated on October 17, 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 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: August 16, 2026.

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

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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 is a graduate of Other (2023).

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

Phone(517) 205-4800

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

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority 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

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.

SAMANTHA RENE DANEK PA-C

Physician Assistant