Individual provider Active NPI

Cristina Carolina Romero de Montero, MD

  • Pediatrics Physician
  • San Juan Capistrano, CA
National Provider Identifier
1003171604
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A137934 Issued in CA
Practice address
30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Phone
(949) 240-2030
Fax
(949) 240-5869
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A137934 CA Primary
Pediatrics Physician 208000000X 265643 NY

Addresses

Primary practice location

30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304

Mailing address

30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Phone (949) 240-2030

Other names 1

  • Dr. Cristina Carolina Romero Henriquez Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221002662 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9032368444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A137934CAMDPediatrics Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1003171604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30300 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751304",
            "telephone_number": "949-240-2030",
            "fax_number": "949-240-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30300 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751304",
            "telephone_number": "949-240-2030",
            "fax_number": "949-240-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO DE MONTERO",
        "first_name": "CRISTINA",
        "middle_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A137934",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "265643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINA",
            "last_name": "ROMERO HENRIQUEZ",
            "middle_name": "CAROLINA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Juan Capistrano, CA

Sources for this page

Verify at the official NPI Registry.