Shelisha Roach, APRN in Hartford, CT - Medicare Nurse Practitioner

Shelisha Roach, APRN is a medicare enrolled "Nurse Practitioner - Family" in Hartford, Connecticut. Her current practice location is 85 Seymour St Ste 125b, Hartford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 962-7022.

Shelisha Roach is licensed to practice in Connecticut (license number 14758) 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 1629627708.

Contact Information

	Shelisha Roach, APRN
	85 Seymour St Ste 125b, Hartford, CT 06106-5501
	(860) 962-7022
	Not Available

Map and Direction

Provider's Profile

Full Name	Shelisha Roach
Gender	Female
Speciality	Nurse Practitioner - Family
Location	85 Seymour St Ste 125b, Hartford, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1629627708
Provider Enumeration Date: 09/10/2019
Last Update Date: 08/20/2025

Medicare PECOS Information:

PECOS PAC ID: 7719362581
Enrollment ID: I20220914001865

Medical Identifiers

Medical identifiers for Shelisha Roach such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629627708	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	F349466 (New York)	Secondary
363LF0000X	Nurse Practitioner - Family	14758 (Connecticut)	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. Shelisha Roach allows following entities to bill medicare on her behalf.

Entity Name	Fulton Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841635133 PECOS PAC ID: 8527201540 Enrollment ID: O20130823000424

Entity Name	Daniel S Berman Md Infectious Diseases Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972018208 PECOS PAC ID: 2567723562 Enrollment ID: O20180308002033

Entity Name	Daniel Novick Md Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770327447 PECOS PAC ID: 0143754341 Enrollment ID: O20241111002856

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. Shelisha Roach 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
Shelisha Roach, APRN 85 Seymour St Ste 125b, Hartford, CT 06106-5501 Ph: (860) 962-7022	Shelisha Roach, APRN 85 Seymour St Ste 125b, Hartford, CT 06106-5501 Ph: (860) 962-7022

Reviews and Comments

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Marlo L Derla, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 31 Seymour St, Hartford, CT 06106 Phone: 860-972-0475
Olivia Holubecki, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 282 Washington St, Hartford, CT 06106 Phone: 860-545-9290

Shelisha Roach, APRN - Medicare Nurse Practitioner in Hartford, CT