Ivelisse Roman, in Middletown, NY - Medicare Counselor Provider

Ivelisse Roman, is a medicare enrolled "Counselor - Mental Health" provider in Middletown, New York. Her current practice location is 15 Fortune Rd W, Middletown, New York. You can reach out to her office (for appointments etc.) via phone at (845) 673-7123.

Ivelisse Roman is licensed to practice in New York (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811586795.

Contact Information

	Ivelisse Roman,
	15 Fortune Rd W, Middletown, NY 10941-1625
	(845) 673-7123
	(845) 692-2889

Map and Direction

Healthcare Provider's Profile

Full Name	Ivelisse Roman
Gender	Female
Speciality	Counselor - Mental Health
Location	15 Fortune Rd W, Middletown, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811586795
Provider Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021

Medicare PECOS Information:

PECOS PAC ID: 4880035500
Enrollment ID: I20240513002978

Medical Identifiers

Medical identifiers for Ivelisse Roman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811586795	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ivelisse Roman allows following entities to bill medicare on her behalf.

Entity Name	Senior Care Therapy Lcsw Of New York Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932677168 PECOS PAC ID: 7113269010 Enrollment ID: O20190424002784

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ivelisse Roman is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ivelisse Roman, 15 Fortune Rd W, Middletown, NY 10941-1625 Ph: (845) 673-7123	Ivelisse Roman, 15 Fortune Rd W, Middletown, NY 10941-1625 Ph: (845) 673-7123

Reviews and Comments

Counselor in Middletown, NY

Stephanie Brauch, MHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 41 Dolson Ave, Middletown, NY 10940 Phone: 845-342-5789 Fax: 845-344-0510
Ann M Willis, MS, CASAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 420 E Main St, Middletown, NY 10940 Phone: 845-342-5300 Fax: 845-342-5602
Karlin Dhariana Walcott, LMHC, CASAC Counselor Medicare: Medicare Enrolled Practice Location: 305 North St, Middletown, NY 10940 Phone: 845-343-7675 Fax: 845-343-2501
Ms. Deborah Strock, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 16 Union St, Middletown, NY 10940 Phone: 845-343-5556
Miss Samantha Favara, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 41 Dolson Ave, Middletown, NY 10940 Phone: 845-342-5789 Fax: 845-344-0510
Ms. Patricia Marie Moore, LMSW, CASAC2 Counselor Medicare: Not Enrolled in Medicare Practice Location: 15 Fortune Rd W, Middletown, NY 10941 Phone: 888-750-2266
Melissa Sue Quinn, MHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 24 Union St, Middletown, NY 10940 Phone: 845-421-6336 Fax: 845-341-0226

Ivelisse Roman, - Medicare Counselor in Middletown, NY