Individual provider Active NPI

Jose R Romero, MD

  • Pediatric Infectious Diseases Physician
  • Little Rock, AR
National Provider Identifier
1205887163
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
E-5819 Issued in AR
Practice address
1 Childrens Way # 512-11
Little Rock, AR 72202-3500
Phone
(501) 364-1416
Fax
(501) 364-3551
NPI assigned
May 15, 2006
Last updated
Mar 11, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 19225 NE
Pediatric Infectious Diseases Physician 2080P0208X E-5819 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-11
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 512-11
Little Rock, AR 72202-3500
Phone (501) 364-1416

Other identifiers 2

IdentifierTypeStateIssuer
47078557559MedicaidNE
124801001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081022000758 AR Practitioner - Infectious DiseasePractitioner - Pediatric Medicine 3072537059 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19225NEMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 26, 2008 Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 441-3453

1 Childrens Way
#51211
Little Rock, AR 72202
Phone (501) 364-1416

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

Organizations & group practices 2

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1205887163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-11",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1416",
            "fax_number": "501-364-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-11",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1416",
            "fax_number": "501-364-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NE",
            "license": "19225",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "AR",
            "license": "E-5819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47078557559",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124801001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.