Dominic Xavier Romero, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

318 S 6TH Ave
Pocatello, ID 83201-5809

Phone

(575) 993-2495

NPI assigned

Aug 22, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paul D. Reicherter, MD, PCGroup PAC ID 4082687298, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: dromero1@advskinctr.emadirect.md

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.

• Paul D. Reicherter, MD, PC

  • Clinical & Laboratory Dermatological Immunology Physician
  • Roseburg, OR
  • NPI 1407055437
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1356060693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 S 6TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015809",
            "telephone_number": "575-993-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 S 6TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015809",
            "telephone_number": "575-993-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "DOMINIC",
        "middle_name": "XAVIER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002673011",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ney Jimmy David Rodriguez Jr.
• Heather L. Rogers, M.S. CCC-SLP
• Trey Rogers, D.O.
• Zachariah Lee Rollins, PA-C
• Jessica J Rolynn, MD
• Dwight Romriell
• Garett Warner Romriell, OTR
• Gregory E Romriell, D.M.D.
• Steven D Romriell, PTA
• Root and Rise Pediatric Therapy LLC

• Physician Assistant in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.