Organization Active NPI

Federico Roman NG, Mdpa

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1053677351
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J6623 Issued in TX
Legal business name
FEDERICO ROMAN NG, MDPA
Practice address
7922 Ewing Halsell Dr
Suite 270
San Antonio, TX 78229-3786
Phone
(210) 614-2828
Fax
(210) 614-2558
NPI assigned
Apr 11, 2012
Last updated
Apr 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Authorized official

Name
Dr. Federico Roman NG, M.D.NPI 1528061488
Title
Owner
Phone
(210) 614-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J6623 TX Primary

Addresses

Primary practice location

7922 Ewing Halsell Dr
Suite 270
San Antonio, TX 78229-3786

Mailing address

7922 Ewing Halsell Dr
Suite 270
San Antonio, TX 78229-3786
Phone (210) 614-2828

Other identifiers 1

IdentifierTypeStateIssuer
1528061488OtherTXNPI-INDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120810000301 TX Part B Supplier - Clinic/Group Practice 4880840602 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

7922 Ewing Halsell Dr
San Antonio, TX 78229

7922 Ewing Halsell Dr
Ste 270
San Antonio, TX 78229
Phone (210) 614-2828

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1053677351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7922 EWING HALSELL DR",
            "address_2": "SUITE 270",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293786",
            "telephone_number": "210-614-2828",
            "fax_number": "210-614-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7922 EWING HALSELL DR",
            "address_2": "SUITE 270",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293786",
            "telephone_number": "210-614-2828",
            "fax_number": "210-614-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERICO ROMAN NG, MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "NG",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_middle_name": "ROMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-614-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J6623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-INDIVIDUAL",
            "identifier": "1528061488",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.