IVELISSE ROMAN
NPI 1811586795
Counselor - Mental Health in Middletown, NY

Q: What is Ivelisse Roman's NPI number?

The NPI number for Ivelisse Roman is 1811586795. It was assigned to this individual provider in the NPPES registry on January 14, 2021.

Q: What is Ivelisse Roman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Ivelisse Roman was last updated on February 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 January 14, 2021PECOS EnrolledAccepts Medicare Assignment

15 FORTUNE RD W, MIDDLETOWN, NY 10941(845) 673-7123(845) 692-2889 Get Directions Write a Review

NPPES record last updated: February 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Ivelisse Roman NPPES

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

IVELISSE ROMAN (NPI 1811586795) is an individual mental health provider in Middletown, New York, licensed in New York (013057) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Bayside, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1811586795

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameIVELISSE ROMAN

Location Address15 FORTUNE RD WMiddletown, NY 10941-1625

Mailing Address15 Fortune Rd WMiddletown, NY 10941-1625 · (845) 673-7123 · Fax (845) 692-2889

Phone(845) 673-7123

Fax(845) 692-2889

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateJanuary 14, 2021

Last NPPES UpdateFebruary 26, 2026

NPPES CertifiedFebruary 26, 2026

✔ NPI 1811586795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in NY · 013057

15 FORTUNE RD W, Middletown, NY 10941

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Secondary Practice Location 1

Location 13635 Bell Blvd Ste 203Bayside, NY 11361-2097 · Phone (718) 504-9256 ext. 49256

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Health.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

Ivelisse Roman 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 ID4880035500

PECOS Enrollment IDI20240513002978

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 Ivelisse Roman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Comprehensive Counseling Lcsw, PLLC

58 mi

Clinical

3635 BELL BLVD STE 203
Bayside, NY 11361

Reassigned Medicare billing, New York enrollment
163 clinicians in this Medicare group

NPI 1982798773 (718) 830-0246

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.

125 services60 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

22 services22 patients

Psychotherapy, 45 minutes 90834

Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.

16 services12 patients

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.

CHRISTINE MARGARET MACKAY RN

Registered Nurse (Psychiatric/Mental Health)