Individual provider Active NPI

Al Lagman Romero, MD

  • Family Medicine Physician
  • Escanaba, MI
National Provider Identifier
1295736114
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301063755 Issued in MI
Practice address
2500 7TH Ave S
Escanaba, MI 49829-1176
Phone
(906) 786-4628
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301063755 MI Primary
Family Medicine Physician 207Q00000X C51658 CA

Addresses

Primary practice location

2500 7TH Ave S
Escanaba, MI 49829-1176

Mailing address

2500 7TH Ave S
Escanaba, MI 49829-1176
Phone (906) 786-4628

Other identifiers 3

IdentifierTypeStateIssuer
351048205OtherECFMG
464159710MedicaidMI
4301063755OtherMICONTROLLED SUBSTANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130814000986 CA Practitioner - Family Practice 8224020896 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301063755MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Ascension Macomb Oakland Hospital Past Accepting new patients
Pavilion Family Practice PC PastSince Jul 1, 2003 Accepting new patients
University Family Physicians Family Medicine Past Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFDBA

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295736114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 7TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291176",
            "telephone_number": "906-786-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 7TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291176",
            "telephone_number": "906-786-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "AL",
        "middle_name": "LAGMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301063755",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C51658",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "351048205",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464159710",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "4301063755",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.