Individual provider Active NPI

Roman Johnson, M.D.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1124264148
Registry record updated Mar 26, 2019
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Jan 19, 2017.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
250497 Issued in NY
Practice address
41 Division St
Apt. 5 Fa
New York, NY 10002-6700
Phone
(603) 381-4195
NPI assigned
Dec 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 250497 NY
Anesthesiology Physician 207L00000X 250497 NY Primary

Addresses

Primary practice location

41 Division St
Apt. 5 Fa
New York, NY 10002-6700

Mailing address

80 Chambers St Apt 14C
New York, NY 10007-1991
Phone (603) 381-4194

Other practice location 1

80 Chambers St Apt 14C
New York, NY 10007-1991
Phone (603) 381-4194

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1124264148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 CHAMBERS ST APT 14C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071991",
            "telephone_number": "603-381-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 DIVISION ST",
            "address_2": "APT. 5 FA",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100026700",
            "telephone_number": "603-381-4195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Chambers St Apt 14C",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100071991",
            "country_code": "US",
            "telephone_number": "603-381-4194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "250497",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "250497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.