Edwin Roman, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD063687L Issued in PA

Practice address

1009 Broad St
Suite 1
Montoursville, PA 17754-2509

Phone

(570) 368-8389

Fax

(570) 368-8391

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Susquehanna Physician Services

  • Physical Medicine & Rehabilitation Physician
  • Williamsport, PA
  • NPI 1629006606
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1376511048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 BROAD ST",
            "address_2": "SUITE 1",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177542509",
            "telephone_number": "570-368-8389",
            "fax_number": "570-368-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 BROAD ST",
            "address_2": "SUITE 1",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177542509",
            "telephone_number": "570-368-8389",
            "fax_number": "570-368-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD063687L",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD063687L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "804291",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "969730",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "2378143",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016591210002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "897668",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50054359",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHAMERICA",
            "identifier": "G56772",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Reichard, PHARM D
• Madelyn Maureen Reitz, PA-C
• Maegan E Reitz, PAC
• Gregg F Rhodes, DC
• Codi C Rittenhouse, BS
• Scott D Rosenberg
• Robert Ross
• Letitia Saylor, CRNA
• Lisa C. Schaeffer, PT
• William George Schlachter, R.PH., FASCP, CGP

• Physical Medicine & Rehabilitation Physician in Montoursville, PA
• Providers in Montoursville, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.