Individual provider Active NPI

Bradley J Romsa, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • New Hyde Park, NY
National Provider Identifier
1316203979
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
059492 Issued in NY
Practice address
2001 Marcus Ave Ste N10
New Hyde Park, NY 11042
Phone
(516) 775-1818
Fax
(516) 775-0892
NPI assigned
Apr 9, 2012
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 059492 NY Primary

Addresses

Primary practice location

2001 Marcus Ave Ste N10
New Hyde Park, NY 11042

Mailing address

2001 Marcus Ave Ste N10
New Hyde Park, NY 11042-2048
Phone (516) 775-1818

Other practice location 1

800 Poly Pl
Brooklyn, NY 11209-7104
Phone (718) 836-6600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809000824 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 3678821568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059492NYMDPharmacist

Organizations & group practices 1

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": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1316203979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE N10",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422048",
            "telephone_number": "516-775-1818",
            "fax_number": "516-775-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE N10",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-775-1818",
            "fax_number": "516-775-0892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Poly Pl",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097104",
            "country_code": "US",
            "telephone_number": "718-836-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMSA",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "059492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.