Organization Active NPI

Northeast Florida Cardiology PA

  • Cardiovascular Disease Physician
  • Palatka, FL
National Provider Identifier
1366649766
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME60213 Issued in FL
Legal business name
NORTHEAST FLORIDA CARDIOLOGY PA
Practice address
6710 Old Wolf Bay Rd
Palatka, FL 32177-6830
Phone
(386) 326-1590
Fax
(386) 326-1592
NPI assigned
Jun 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alfred Thomas Romero, M.D.NPI 1063597912
Title
Director
Phone
(904) 347-9204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X ME60213 FL Primary

Addresses

Primary practice location

6710 Old Wolf Bay Rd
Palatka, FL 32177-6830

Mailing address

5000 US Highway 17
Suite 18 #288
Orange Park, FL 32003-8231
Phone (904) 347-9204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050331000268 FL Part B Supplier - Clinic/Group Practice 4385691518 Receives reassigned benefits from 1 practitioner
Practice locations: Palatka, FL

National Provider Directory

National Provider Directory

Locations

5000 US Highway 17
Orange Park, FL 32003
Phone (904) 269-2270

5000 US Highway 17
Ste 18288
Orange Park, FL 32003

6710 Old Wolf Bay Rd
Palatka, FL 32177
Phone (386) 326-1590

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366649766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 US HIGHWAY 17",
            "address_2": "SUITE 18 #288",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320038231",
            "telephone_number": "904-347-9204",
            "fax_number": "386-326-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 OLD WOLF BAY RD",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776830",
            "telephone_number": "386-326-1590",
            "fax_number": "386-326-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA CARDIOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-347-9204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME60213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.