Individual provider Active NPI

Maile G Roman, FNP

  • Family Nurse Practitioner
  • Sunnyvale, TX
National Provider Identifier
1265984751
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132474 Issued in TX
Practice address
3615 N Belt Line Rd Ste 300
Sunnyvale, TX 75182-9235
Phone
(972) 682-7500
Fax
(972) 682-7695
NPI assigned
Oct 31, 2016
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132474 TX Primary

Addresses

Primary practice location

3615 N Belt Line Rd Ste 300
Sunnyvale, TX 75182-9235

Mailing address

PO Box 12171
Dallas, TX 75225-0171
Phone (972) 682-7500

Other names 1

  • Maile Kaliko Galacgac Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170525000642 TX Practitioner - Nurse Practitioner 8921375841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Wound Care Specialists LLCGroup PAC ID 4183097983, 7 clinicians

Practice addresses (Care Compare)

6300 W Parker Rd
Medical Office Building 2 Suite 128
Plano, TX 75093-8100
Phone (253) 223-9333

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Wound Care Specialists LLC CurrentSince Feb 1, 2023 Accepting new patients
Cardiac and Vascular Center, P.C. CurrentSince Sep 16, 2024 Accepting new patients
Healogics Specialty Physicians of Texas, PLLC Past Accepting new patients
Sound Integrated Health LLC PastSince Jan 1, 2020 Accepting new patients

Locations

2900 N I 35
Ste 205
Denton, TX 76201
Phone (940) 898-7182

6300 W Parker Rd
Ofc
Plano, TX 75093
Phone (253) 223-9333

6300 W Parker Rd
Ste 128
Plano, TX 75093
Phone (214) 550-2099

3615 N Belt Line Rd
Ste 300
Sunnyvale, TX 75182
Phone (972) 682-7500

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1265984751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12171",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752250171",
            "telephone_number": "972-682-7500",
            "fax_number": "972-682-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 N BELT LINE RD STE 300",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751829235",
            "telephone_number": "972-682-7500",
            "fax_number": "972-682-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "MAILE",
        "middle_name": "G",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAILE",
            "last_name": "GALACGAC",
            "middle_name": "KALIKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sunnyvale, TX

Sources for this page

Verify at the official NPI Registry.