Individual provider Active NPI

Irene Paula San Roman, M.D.

  • Internal Medicine Physician
  • Hampton, VA
National Provider Identifier
1023071057
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101239657 Issued in VA
Practice address
100 Emancipation Dr
Hampton, VA 23667-0001
Phone
(757) 722-9961
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101239657 VA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 0101239657 VA

Addresses

Primary practice location

100 Emancipation Dr
Hampton, VA 23667-0001

Mailing address

5111 Gleneagles Way
Suffolk, VA 23435-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20130806000911 NM Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 7719129683

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101239657VAMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023071057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 GLENEAGLES WAY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234354206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EMANCIPATION DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236670001",
            "telephone_number": "757-722-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN ROMAN",
        "first_name": "IRENE",
        "middle_name": "PAULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101239657",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101239657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.