Individual provider Active NPI

Yazmin Yadira Roman Perez

  • Nutritionist
  • Canovanas, PR
National Provider Identifier
1356508832
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1395 Issued in PR
Practice address
Carretera 3 KM 199
Canovanas, PR 00729-0000
Phone
(787) 256-5555
Fax
(787) 256-5555
NPI assigned
May 21, 2008
Last updated
May 21, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1395 PR Primary

Addresses

Primary practice location

Carretera 3 KM 199
Canovanas, PR 00729-0000

Mailing address

K16 Calle Anon
Valle Arriba Heights
Carolina, PR 00983-3464
Phone (787) 602-9431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260408004049 PR Practitioner - Registered Dietitian Or Nutrition Professional 4688149438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Carr 190
8 Sabana Abajo
Carolina, PR 00983-7401
Phone (787) 789-1996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1395PRMDNutritionist

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1356508832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "K16 CALLE ANON",
            "address_2": "VALLE ARRIBA HEIGHTS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009833464",
            "telephone_number": "787-602-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 3 KM 199",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007290000",
            "telephone_number": "787-256-5555",
            "fax_number": "787-256-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN PEREZ",
        "first_name": "YAZMIN",
        "middle_name": "YADIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "1395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.