MARIE ROUSSAW NP - NPI 1649107988 - Nurse Practitioner in Lilburn, GA

Q: 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.

Q: What is Marie Roussaw's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: 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 2 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.

On this page

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.

NPPES Registry Identity

NPI1649107988

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMARIE ROUSSAWCredential: NP

Location Address483 INDIAN TRAIL LILBURN RD NWLilburn, GA 30047-3717

Mailing Address820 Gateshead LnLawrenceville, GA 30043-6668 · (302) 559-4588

Phone(770) 923-4433

Sole ProprietorYes

Enumeration DateMay 8, 2026

NPPES CertifiedMay 8, 2026

✔ NPI 1649107988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in GA · APRN-NP242283

483 INDIAN TRAIL LILBURN RD NW, Lilburn, GA 30047

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marie Roussaw Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 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.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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 5

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

BELINDA I OPARA NURSE PRACTITIONER

Nurse Practitioner (Family)