Individual provider Active NPI

Javier A Roman, MS, DC

  • Chiropractor
  • Tamarac, FL
National Provider Identifier
1093134868
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11271 Issued in FL
Practice address
7301 N University Dr Ste 100
Tamarac, FL 33321-2909
Phone
(516) 614-2979
NPI assigned
Apr 9, 2014
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 528 PR
Chiropractor 111N00000X CH11271 FL Primary

Addresses

Primary practice location

7301 N University Dr Ste 100
Tamarac, FL 33321-2909

Mailing address

410 Victory Cir
Boynton Beach, FL 33436-2876
Phone (516) 614-2979

Other practice location 1

6979 Stirling Rd
Davie, FL 33314-7005
Phone (516) 614-2979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250328001901 PR Practitioner - Chiropractic 4385943869 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CH11271FLMDChiropractor
528PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Quiropractico del Parque CSP Chiropractor CurrentSince Feb 1, 2025 Accepting new patients
Carlos Selles Hernandez Centro Quriropractico del Parque Chiropractor PastSince Feb 1, 2025 Accepting new patients

Locations

146 Calle del Parque
Santurce, PR 00911
Phone (787) 722-5422

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1093134868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 VICTORY CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334362876",
            "telephone_number": "516-614-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 N UNIVERSITY DR STE 100",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212909",
            "telephone_number": "516-614-2979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6979 Stirling Rd",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333147005",
            "country_code": "US",
            "telephone_number": "516-614-2979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "JAVIER",
        "middle_name": "A",
        "credential": "MS, DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PR",
            "license": "528",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.