Michael Conrad Roman, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS009124L Issued in PA

Practice address

1550 W Main St
Jeffersonville, PA 19403-3228

Phone

(610) 635-1712

Fax

(610) 635-1716

NPI assigned

Apr 11, 2006

Last updated

Apr 15, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Internal Medicine

Education

Philadelphia College of Osteopathic Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gentiva I Hospice, Blue Bell, PA, CCN 391622
• Heartland Hospice (Chadds Ford) Hospice, Chadds Ford, PA, CCN 391684
• Aristacare at Meadow Springs Nursing home, Plymouth Meeting, PA, CCN 395019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Jeffersonville Internal Medicine, P.C.

  • General Practice Physician
  • Jeffersonville, PA
  • NPI 1831131564

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Pennsylvania Department of Human Services

  dba Norristown State Hospital

  • Psychiatric Hospital
  • Norristown, PA
  • NPI 1447233317
  Medicare reassignment
• Rosen Medical Associates

  • Rheumatology Physician
  • West Chester, PA
  • NPI 1063657583
  NPD (past)
• Schuylkill Internal Medicine Associates LLC

  dba Family Medicine Collegeville Tower Health Medical Group

  • Internal Medicine Physician
  • Collegeville, PA
  • NPI 1912192337
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Plymouth Healthcare Associates, LLC

  dba AristaCare at Meadow Springs

  • Skilled Nursing Facility
  • Plymouth Meeting, PA
  • NPI 1760436828

  Nursing home

  Care Compare affiliation
• Southerncare, Inc.

  dba Heartland

  • Community Based Hospice Care Agency
  • Chadds Ford, PA
  • NPI 1275232795
  Care Compare affiliation
• Vistacare USA, LLC

  dba Gentiva I

  • Community Based Hospice Care Agency
  • Blue Bell, PA
  • NPI 1164478103
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1073576849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 W MAIN ST",
            "city": "JEFFERSONVILLE",
            "state": "PA",
            "postal_code": "194033228",
            "telephone_number": "610-635-1712",
            "fax_number": "610-635-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W MAIN ST",
            "city": "JEFFERSONVILLE",
            "state": "PA",
            "postal_code": "194033228",
            "telephone_number": "610-635-1712",
            "fax_number": "610-635-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "MICHAEL",
        "middle_name": "CONRAD",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS009124L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017066150002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Huub Jozef Mulders, MD
• Maria Pena-Ariet, M.D.
• Lindsay Anne Phillips, PSY.D.
• Ruth Rincker, LCSW
• Rite Aid of Pennsylvania LLC (Rite Aid Pharmacy 01733)
• Rajnikant K Shah, B.D.S, M.D.S
• Christiana Jo Silcox, LPC, NCC
• James W Stein, DC
• The Neuropsychiatric Group
• Taylor Tomlinson

• Internal Medicine Physician in Jeffersonville, PA
• Providers in Jeffersonville, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.