Active NPI
Nicholas M Romano Jr., MD
- Family Medicine Physician
- Bangor, PA
National Provider Identifier
1104853423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD021161E
- Practice address
- 104 S 2ND St
Bangor, PA 18013-2504 - Phone
- (610) 588-3133
- Fax
- (610) 588-5138
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD021161E | PA | Primary |
Addresses
Primary practice location
104 S 2ND St
Bangor, PA 18013-2504
Mailing address
104 S 2ND St
Bangor, PA 18013-2504
Phone (610) 588-3133
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01597601 | Other | PA | CAPITAL BLUE CROSS |
| 124304 | Other | PA | BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northampton Clinic Company LLC | Past | Accepting new patients | |
| Northampton Clinic Company LLC | Family Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
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- NPI 1952633596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367193600000",
"number": "1104853423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 S 2ND ST",
"city": "BANGOR",
"state": "PA",
"postal_code": "180132504",
"telephone_number": "610-588-3133",
"fax_number": "610-588-5138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 S 2ND ST",
"city": "BANGOR",
"state": "PA",
"postal_code": "180132504",
"telephone_number": "610-588-3133",
"fax_number": "610-588-5138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMANO",
"first_name": "NICHOLAS",
"middle_name": "M",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2013-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD021161E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01597601",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "124304",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bangor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.