Individual provider Active NPI

Romeo Suba Cayanan, NP

  • Primary Care Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1194818849
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F302331 Issued in NY
Practice address
36-11 21St St
Long Island City, NY 11106-4505
Phone
(718) 482-7772
Fax
(718) 482-9648
NPI assigned
Oct 2, 2006
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F302331 NY Primary

Addresses

Primary practice location

36-11 21St St
Long Island City, NY 11106-4505

Mailing address

60 Madison Ave FL 5
New York, NY 10010-1600
Phone (125) 452-4002

Other practice location 1

999 Blake Ave
Brooklyn, NY 11208-3535
Phone (718) 277-8303

Other practice location 2

1167 Nostrand Ave
Brooklyn, NY 11225-5417
Phone (718) 778-0198

Other practice location 3

504 W 158th St Fl 5
New York, NY 10032-7202
Phone (917) 521-3130 ext. 3130

Other practice location 4

1880 Bathgate Ave
Bronx, NY 10457-6259
Phone (718) 294-5891

Other practice location 5

94-98 Manhattan Avenue
Brooklyn, NY 11206-2505
Phone (718) 388-0390

Other practice location 6

975 Westchester Ave
Bronx, NY 10459-3204
Phone (718) 320-4466

Other practice location 7

350 Grand St Rm 240
New York, NY 10002-4629
Phone (212) 634-7550 ext. 7556

Other practice location 8

81 W 115th St
New York, NY 10026-3138
Phone (212) 426-0088

Other practice location 9

511 W 157TH St
New York, NY 10032-5058
Phone (212) 781-7979

Other practice location 10

255 E Houston St
New York, NY 10002-1013
Phone (212) 477-1120

Other practice location 11

89-44 164th St
Jamaica, NY 11432-6103
Phone (718) 523-2123

Other practice location 12

80th St & 41st Ave
Elmhurst, NY 11373-1329
Phone (718) 334-2424

Other practice location 13

2581 Atlantic Ave
Brooklyn, NY 11207-2412
Phone (718) 495-6700

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210108001246 NY Practitioner - Nurse Practitioner 9032404496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F302331NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Sep 17, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Sep 17, 2020 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Community Healthcare Network, Inc. Past Accepting new patients
Community Healthcare Network, Inc. Past Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

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, 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1194818849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "125-452-4002",
            "fax_number": "212-463-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36-11 21ST ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064505",
            "telephone_number": "718-482-7772",
            "fax_number": "718-482-9648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 Blake Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112083535",
            "country_code": "US",
            "telephone_number": "718-277-8303",
            "fax_number": "718-277-4795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1167 Nostrand Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112255417",
            "country_code": "US",
            "telephone_number": "718-778-0198",
            "fax_number": "718-221-8169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "504 W 158th St Fl 5",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100327202",
            "country_code": "US",
            "telephone_number": "917-521-3130 x3130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1880 Bathgate Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104576259",
            "country_code": "US",
            "telephone_number": "718-294-5891",
            "fax_number": "718-294-2468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "94-98 Manhattan Avenue",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112062505",
            "country_code": "US",
            "telephone_number": "718-388-0390",
            "fax_number": "718-486-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104593204",
            "country_code": "US",
            "telephone_number": "718-320-4466",
            "fax_number": "718-991-3829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Grand St Rm 240",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100024629",
            "country_code": "US",
            "telephone_number": "212-634-7550 x7556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "81 W 115th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100263138",
            "country_code": "US",
            "telephone_number": "212-426-0088",
            "fax_number": "212-426-8367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "511 W 157TH ST",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100325058",
            "country_code": "US",
            "telephone_number": "212-781-7979",
            "fax_number": "212-781-7963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 E Houston St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100021013",
            "country_code": "US",
            "telephone_number": "212-477-1120",
            "fax_number": "212-477-8957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "89-44 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114326103",
            "country_code": "US",
            "telephone_number": "718-523-2123",
            "fax_number": "718-523-5833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80th St & 41st Ave",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731329",
            "country_code": "US",
            "telephone_number": "718-334-2424",
            "fax_number": "718-334-5958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2581 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112072412",
            "country_code": "US",
            "telephone_number": "718-495-6700",
            "fax_number": "646-988-2840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAYANAN",
        "first_name": "ROMEO",
        "middle_name": "SUBA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F302331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.