Individual provider Active NPI

Rafael Leopoldo Romano

  • Rehabilitation Practitioner
  • Las Vegas, NV
National Provider Identifier
1104408277
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
9480 Graceful Gold St
Las Vegas, NV 89123-3889
Phone
(702) 969-9849
NPI assigned
Apr 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

9480 Graceful Gold St
Las Vegas, NV 89123-3889

Mailing address

9480 Graceful Gold St
Las Vegas, NV 89123-3889
Phone (702) 969-9849

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rafael@fuentedevidanv.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1104408277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9480 GRACEFUL GOLD ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233889",
            "telephone_number": "702-969-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 GRACEFUL GOLD ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891233889",
            "telephone_number": "702-969-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANO",
        "first_name": "RAFAEL",
        "middle_name": "LEOPOLDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rafael@fuentedevidanv.org",
            "affiliation": "N",
            "endpointDescription": "info",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9480 Graceful Gold St",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891233889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.