Organization Active NPI

Eloy Roman MD PA

  • Internal Medicine Physician
  • Miami Lakes, FL
National Provider Identifier
1174756928
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ELOY ROMAN MD PA
Practice address
5801 NW 151St St
Suite 300
Miami Lakes, FL 33014-2437
Phone
(305) 828-1333
Fax
(305) 828-7007
NPI assigned
Aug 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Authorized official

Name
Eloy Roman, MDNPI 1811018765
Title
Owner
Phone
(305) 828-1333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5801 NW 151St St
Suite 300
Miami Lakes, FL 33014-2437

Mailing address

5801 NW 151St St
Suite 300
Miami Lakes, FL 33014-2437
Phone (305) 828-1333

Other identifiers 1

IdentifierTypeStateIssuer
001687600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091231000455 FL Part B Supplier - Clinic/Group Practice 7618018300 Receives reassigned benefits from 1 practitioner
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory
Tax ID family
Eloy Roman MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1174756928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NW 151ST ST",
            "address_2": "SUITE 300",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142437",
            "telephone_number": "305-828-1333",
            "fax_number": "305-828-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NW 151ST ST",
            "address_2": "SUITE 300",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142437",
            "telephone_number": "305-828-1333",
            "fax_number": "305-828-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELOY ROMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "ELOY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-828-1333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001687600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.