Elizabeth Diane Roman, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17459 Issued in CA

Practice address

795 El Camino Real
Palo Alto, CA 94301-2302

Phone

(650) 853-2984

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Diane Reyes Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eroman234950@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1063450625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 EL CAMINO REAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012302",
            "telephone_number": "650-853-2984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2715 Santa Ana St",
            "address_purpose": "LOCATION",
            "city": "South Gate",
            "state": "CA",
            "postal_code": "902802021",
            "country_code": "US",
            "telephone_number": "323-583-0450",
            "fax_number": "323-583-0012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "ELIZABETH",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "REYES",
            "middle_name": "DIANE",
            "credential": "P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelsey Michelle Rogowski, PHARMD
• Stacie Onstad Rohovit, NNP-BC
• Debra D Rojas, LMFT
• Michelle Marie Rojas, MOT, OTR/L
• Kevin William Rolfe, M.D.
• Olivia Catherine Roman, MD
• Inna Romao Da Silva, R.R.T
• Myleen Dumagan Romarate, NP
• Ruby Kassandra Romero Gonzalez
• Ana Romero Morales, PH.D.

• Medical Physician Assistant in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.