Active NPI
Miguel Angel Roman
- Independent Duty Corpsman
- New London, CT
National Provider Identifier
1245674332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 35 Union St
Apt. 521
New London, CT 06320-6136 - Phone
- (787) 247-0572
- NPI assigned
- Apr 19, 2013
- 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 |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
35 Union St
Apt. 521
New London, CT 06320-6136
Mailing address
159 Trout Ave
Groton, CT 06349
Phone (787) 247-0572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7987 | Other | SUBMARINE INDEPENDENT DUTY CORPSMAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1245674332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 TROUT AVE",
"city": "GROTON",
"state": "CT",
"postal_code": "06349",
"telephone_number": "787-247-0572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 UNION ST",
"address_2": "APT. 521",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063206136",
"telephone_number": "787-247-0572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "MIGUEL",
"middle_name": "ANGEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-19",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUBMARINE INDEPENDENT DUTY CORPSMAN",
"identifier": "7987",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.