Individual provider Active NPI

Robert Romatowski, PA

  • Physician Assistant
  • San Angelo, TX
National Provider Identifier
1174556047
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01003 Issued in TX
Practice address
402 N Bryant Blvd
San Angelo, TX 76903-5257
Phone
(325) 655-5125
Fax
(325) 655-5340
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01003 TX Primary
Physician Assistant 363A00000X 4911 OK

Addresses

Primary practice location

402 N Bryant Blvd
San Angelo, TX 76903-5257

Mailing address

402 N Bryant Blvd
San Angelo, TX 76903-5257
Phone (325) 655-5125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040107000808 TX Practitioner - Physician Assistant 5092614164 Reassigns benefits to 2 organizations
I20231003003684 NM Practitioner - Physician Assistant 5092614164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4911OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Aug 30, 2023 Accepting new patients
Regional Employee Assistance Program Inc Physician Assistant CurrentSince Apr 1, 2016 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Apr 1, 2016 Accepting new patients
Tom Green Emergency Medicine Associates PA Past Accepting new patients
West Loop Medical Clinic Inc Past Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

2804 Lake Rd
Ste 5
Huntsville, TX 77340
Phone (979) 696-2422

402 N Bryant Blvd
San Angelo, TX 76903
Phone (325) 655-5125

3535 Knickerbocker Rd
San Angelo, TX 76904
Phone (915) 947-6495

3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361

Interoperability endpoints

  • Direct secure messaging: rromatowski38942@shannonhealth.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1174556047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N BRYANT BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035257",
            "telephone_number": "325-655-5125",
            "fax_number": "325-655-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N BRYANT BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035257",
            "telephone_number": "325-655-5125",
            "fax_number": "325-655-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMATOWSKI",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01003",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.