Individual provider Active NPI

Dominic Romero, PA-C

  • Medical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1023585163
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
201 Cedar St SE Ste 6600
Albuquerque, NM 87106-5411
Phone
(505) 724-4300
NPI assigned
Oct 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

201 Cedar St SE Ste 6600
Albuquerque, NM 87106-5411

Mailing address

11055 Fort Point LN NE
Albuquerque, NM 87123-2675
Phone (505) 231-7136

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190103001761 NM Practitioner - Physician Assistant 6002152592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New Mexico School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2100 Louisiana Blvd NE
Suite 410
Albuquerque, NM 87110-5412
Phone 50572443003208

2101 Unser Blvd SE
Nmo Rio Rancho Clinic
Rio Rancho, NM 87124-6378
Phone (505) 724-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: dromero273964@ahs.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1023585163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11055 FORT POINT LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232675",
            "telephone_number": "505-231-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 6600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065411",
            "telephone_number": "505-724-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "DOMINIC",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.