Individual provider Active NPI

Peter Antoni Roman, MD

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1154944031
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.148422 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-2434
Fax
(216) 844-2288
NPI assigned
May 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 57.249590 OH
Internal Medicine Physician 207R00000X 35.148422 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

2351 E 22ND St
Cleveland, OH 44115-3111
Phone (216) 861-6200

Other identifiers 1

IdentifierTypeStateIssuer
57.249590OtherOHSTATE MEDICAL BOARD OF OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711001954 OH Practitioner - Hospice/Palliative Care 8527503770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

  • University Hospitals Ahuja Medical Center Hospital, Beachwood, OH, CCN 360359
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.249590OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Multicare Health System Multi-Specialty Past Accepting new patients

Locations

3619 Park East Dr
Ste 109
Beachwood, OH 44122
Phone (216) 464-6210

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

2351 E 22nd St
Cleveland, OH 44115
Phone (216) 363-2536

11100 Euclid Ave
Cleveland Heights, OH 44106

Interoperability endpoints

  • Direct secure messaging: proman219713@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1154944031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-861-6200",
            "fax_number": "216-363-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-2434",
            "fax_number": "216-844-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "PETER",
        "middle_name": "ANTONI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.249590",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.148422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD OF OHIO",
            "identifier": "57.249590",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.