NPIMap

Individual provider Active NPI

Joseph Jason Roman, MD

  • Internal Medicine Physician
  • College Station, TX
National Provider Identifier
1023166717
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M6365 Issued in TX
Practice address
1602 Rock Prairie Rd
Suite 4880
College Station, TX 77845-8306
Phone
(979) 796-1111
Fax
(979) 764-1164
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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 23489 OK
Internal Medicine Physician 207R00000X M6365 TX Primary

Addresses

Primary practice location

1602 Rock Prairie Rd
Suite 4880
College Station, TX 77845-8306

Mailing address

1602 Rock Prairie Rd
Suite 4880
College Station, TX 77845-8306
Phone (979) 764-1111

Other identifiers 2

IdentifierTypeStateIssuer
186719401MedicaidTX
8K7733OtherTXBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000656 TX Practitioner - Internal Medicine 2567569171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

1602 Rock Prairie Rd
Suite 3000
College Station, TX 77845-5989
Phone (979) 774-0012

1602 Rock Prairie Rd
Suite 4880
College Station, TX 77845-5992
Phone (979) 690-4470

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23489OKMDInternal Medicine Physician
M6365TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Jul 1, 2007 Accepting new patients
Regional Employee Assistance Program Inc Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
St Joseph Regional Health Center CurrentSince Aug 1, 2019 Accepting new patients
St. Joseph Regional Health Center Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Regional Employee Assistance Program Inc Internal Medicine Current Accepting new patients
College Station Hospital LP Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

Interoperability endpoints

  • Direct secure messaging: joseph.roman@sjrhc.eclinicaldirectplus.com
  • Direct secure messaging: jroman458235@direct.stlukeshealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1023166717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD",
            "address_2": "SUITE 4880",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458306",
            "telephone_number": "979-764-1111",
            "fax_number": "979-693-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD",
            "address_2": "SUITE 4880",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458306",
            "telephone_number": "979-796-1111",
            "fax_number": "979-764-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "JOSEPH",
        "middle_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "23489",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M6365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186719401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8K7733",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.