Romeo Gonzaga Icasiano, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

37326 Issued in CO

Practice address

947 So 5TH St
Montrose, CO 81401-5716

Phone

(870) 249-2421

Fax

(970) 249-8897

NPI assigned

Aug 2, 2005

Last updated

Apr 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: romeo.icasiano.1@11212.direct.athenahealth.com

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.

• Montrose Memorial Hospital, Inc

  dba Montrose Regional Health

  • General Acute Care Hospital
  • Montrose, CO
  • NPI 1205822186
  NPD (past)
• Pediatric Associates Prof LLC

  • Rural Health Clinic/Center
  • Delta, CO
  • NPI 1043016124
  NPD (past)
• Pediatric Associates Prof LLC

  dba The Pediatric Associates

  • Pediatrics Physician
  • Montrose, CO
  • NPI 1548261324
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1114928066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 SO 5TH ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015716",
            "telephone_number": "870-249-2421",
            "fax_number": "970-249-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 SO 5TH ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015716",
            "telephone_number": "870-249-2421",
            "fax_number": "970-249-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICASIANO",
        "first_name": "ROMEO",
        "middle_name": "GONZAGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "37326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01373265",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Allison Hunt, RN BSN
• Robert Lee Hunt, P.T.
• Karen Murlin Hunter, PHARM D
• Hygienist Next Door
• Carol P Ibach, CNS, RXN, APRN
• Roy G Icasiano, P.T.
• Karen S Ickes, MA
• Laura Ann Ickes, MS
• Ignite Change Counseling, LLC
• In Motion Hand Therapy Inc (In Motion Therapy)

• Pediatrics Physician in Montrose, CO
• Providers in Montrose, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; 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.