NPIMap

Individual provider Active NPI

Kristen Leigh Roman, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1174942262
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04917 Issued in NC
Practice address
20 Duke Medicine Circle Duke Cancer Center Clinic 5-1
Durham, NC 27710-4699
Phone
(919) 668-8108
Fax
(919) 613-3900
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 0010-04917 NC
Physician Assistant 363A00000X PA09063 TX
Physician Assistant 363A00000X 0010-04917 NC Primary

Addresses

Primary practice location

20 Duke Medicine Circle Duke Cancer Center Clinic 5-1
Durham, NC 27710-4699

Mailing address

905 Lasalle Street Dumc 103861
Durham, NC 27710-0001
Phone (919) 668-8108

Other identifiers 1

IdentifierTypeStateIssuer
335681801MedicaidTX

Other names 1

  • Kristen Leigh Perez Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180219000717 NC Practitioner - Physician Assistant 7911121017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

300 Ashville Ave
Cary, NC 27518-8682
Phone (919) 854-4588

3400 Wake Forest Rd
Raleigh, NC 27609-7317
Phone (919) 954-3965

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEMPORARYTXMDHematology & Oncology Physician
0010-04917NCMDPhysician Assistant
PA09063TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Sep 24, 2023 Accepting new patients
Duke University Health System, Inc. Current Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Sep 24, 2023 Accepting new patients

Locations

20 Duke Medicine Cir
Durham, NC 27710
Phone (919) 668-6608

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

3404 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 862-5400

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

Interoperability endpoints

  • Direct secure messaging: kjohnston395809@direct.medicine.duke.edu

Organizations & group practices 5

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 6

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1174942262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LASALLE STREET DUMC 103861",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-668-8108",
            "fax_number": "919-613-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 DUKE MEDICINE CIRCLE DUKE CANCER CENTER CLINIC 5-1",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277104699",
            "telephone_number": "919-668-8108",
            "fax_number": "919-613-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "0010-04917",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09063",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335681801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "PEREZ",
            "middle_name": "LEIGH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.