NPIMap

Individual provider Active NPI

Alfred Thomas Romero, M.D

  • Cardiovascular Disease Physician
  • Palatka, FL
National Provider Identifier
1063597912
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME60213 Issued in FL
Practice address
6710 Old Wolf Bay Rd
Palatka, FL 32177-6830
Phone
(386) 326-1590
Fax
(386) 326-1592
NPI assigned
Oct 26, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME60213 FL Primary

Addresses

Primary practice location

6710 Old Wolf Bay Rd
Palatka, FL 32177-6830

Mailing address

5000 US Highway 17
Suite 18 #288
Orange Park, FL 32003-8231
Phone (386) 326-1590

Other identifiers 1

IdentifierTypeStateIssuer
23880OtherFLBCBS OF FLORIDA PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050401000238 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8820045057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6710 Old Wolf Bay Rd
Palatka, FL 32177-6830
Phone (386) 326-1590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME60213FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Florida Cardiology PA Cardiovascular Disease CurrentSince Feb 1, 2005 Accepting new patients
Sparks Medical Foundation Past Accepting new patients
Putnam Heart Center PA Cardiovascular Disease PastSince Jan 1, 2001 Accepting new patients

Locations

5000 US Highway 17
Ste 18
Orange Park, FL 32003
Phone (724) 679-1068

5000 US Highway 17
Ste 18288
Orange Park, FL 32003

6710 Old Wolf Bay Rd
Palatka, FL 32177
Phone (386) 326-1590

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCHDBD/Endpoint/HCHDBD

Organizations & group practices 3

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

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063597912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 US HIGHWAY 17",
            "address_2": "SUITE 18 #288",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320038231",
            "telephone_number": "386-326-1590",
            "fax_number": "386-326-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 OLD WOLF BAY RD",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776830",
            "telephone_number": "386-326-1590",
            "fax_number": "386-326-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "ALFRED",
        "middle_name": "THOMAS",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME60213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA PROVIDER",
            "identifier": "23880",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.