Active NPI
Nayda Ivette Roman, M.D.
- General Practice Physician
- Arecibo, PR
National Provider Identifier
1174738595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 10040
- Practice address
- 205 Callejon Santa Ana
Interior #11
Arecibo, PR 00612-4757 - Phone
- (787) 881-1057
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 10040 | PR | Primary |
Addresses
Primary practice location
205 Callejon Santa Ana
Interior #11
Arecibo, PR 00612-4757
Mailing address
205 Callejon Santa Ana
Interior #11
Arecibo, PR 00612-4757
Phone (787) 881-1057
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10040 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174738595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 CALLEJON SANTA ANA",
"address_2": "INTERIOR #11",
"city": "ARECIBO",
"state": "PR",
"postal_code": "006124757",
"telephone_number": "787-881-1057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 CALLEJON SANTA ANA",
"address_2": "INTERIOR #11",
"city": "ARECIBO",
"state": "PR",
"postal_code": "006124757",
"telephone_number": "787-881-1057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "NAYDA",
"middle_name": "IVETTE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "10040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arecibo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.