MARIE ROUSSAW NP
NPI 1649107988
Nurse Practitioner - Adult Health in Lilburn, GA
About Marie Roussaw Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARIE ROUSSAW NP (NPI 1649107988) is an individual adult health provider in Lilburn, Georgia, licensed in Georgia (APRN-NP242283) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Marie Roussaw Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Marie Roussaw reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lilburn, GA 30047
- Reassigned Medicare billing, Georgia enrollment
- 7 clinicians in this Medicare group
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 30047 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LILBURN, GA 30047
LILBURN, GA 30047
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 Marie Roussaw's NPI number?
The NPI number for Marie Roussaw is 1649107988. It was assigned to this individual provider in the NPPES registry on May 8, 2026.
Where is Marie Roussaw located?
Marie Roussaw practices at 483 Indian Trail Lilburn Rd NW, Lilburn, GA 30047. The listed phone number is (770) 923-4433.
What is Marie Roussaw's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Marie Roussaw enrolled in Medicare?
Yes. Marie Roussaw is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Marie Roussaw's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marie Roussaw reassigns Medicare benefits to Restored Health & Wellness (Lilburn, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marie Roussaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Marie Roussaw was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Marie Roussaw, NP · NPI 1649107988
Adult Health physician in Lilburn, Georgia. Individual provider, active in the CMS NPPES registry since May 8, 2026.
## Identity
- **NPI:** 1649107988 (Entity type: Individual)
- **Enumerated:** May 8, 2026
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** APRN-NP242283 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 483 INDIAN TRAIL LILBURN RD NW, Lilburn, GA 30047-3717
- **Phone:** (770) 923-4433
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Restored Health & Wellness (NPI 1952904369, Lilburn, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** May 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1649107988) · Data from the CMS NPPES public registry.