Individual provider Active NPI

Ryan Elisabeth Romo

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1063974590
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67868 Issued in AZ
Practice address
1705 W Main St
Mesa, AZ 85201-6920
Phone
(877) 809-5092
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 67868 AZ Primary

Addresses

Primary practice location

1705 W Main St
Mesa, AZ 85201-6920

Mailing address

3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808
Phone (877) 809-5092

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230117000978 AZ Practitioner - Family Practice 9335474337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adelante Healthcare, IncGroup PAC ID 4688588643, 132 clinicians

Practice addresses (Care Compare)

1705 W Main St
Mesa, AZ 85201-6920
Phone (877) 809-5092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67868AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Adelante Healthcare, Inc CurrentSince Feb 1, 2023 Accepting new patients
Adelante Healthcare, Inc. Family Medicine Past Accepting new patients

Locations

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1063974590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122808",
            "telephone_number": "877-809-5092",
            "fax_number": "480-718-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 W MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016920",
            "telephone_number": "877-809-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMO",
        "first_name": "RYAN",
        "middle_name": "ELISABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "67868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.