Active NPI
Richard Jeffrey Roman, LCSW
- Clinical Social Worker
- Rome, NY
National Provider Identifier
1184632200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR026982
- Practice address
- 203 W Thomas St
Rome, NY 13440-5007 - Phone
- (315) 337-4435
- Fax
- (315) 337-4435
- NPI assigned
- Aug 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PR026982 | NY | Primary |
Addresses
Primary practice location
203 W Thomas St
Rome, NY 13440-5007
Mailing address
6731 Butts Rd
Rome, NY 13440-8739
Phone (315) 337-4435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180425002729 | NY | Practitioner - Clinical Social Worker | 6204190333 | Practice locations: Rome, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR026982 | NY | MD | Clinical Social Worker |
| 026982 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald D Moore DC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184632200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6731 BUTTS RD",
"city": "ROME",
"state": "NY",
"postal_code": "134408739",
"telephone_number": "315-337-4435",
"fax_number": "315-337-4435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 W THOMAS ST",
"city": "ROME",
"state": "NY",
"postal_code": "134405007",
"telephone_number": "315-337-4435",
"fax_number": "315-337-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "RICHARD",
"middle_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR026982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rome, NY
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.