Individual provider Active NPI

Felix Xavier De Jesus Roman, M.D.

  • Internal Medicine Physician
  • Naugatuck, CT
National Provider Identifier
1386055069
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
056412 Issued in CT
Practice address
131 Bridge St
Naugatuck, CT 06770-2929
Phone
(203) 729-0755
NPI assigned
May 15, 2014
Last updated
Oct 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 056412 CT Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 56412 CT

Addresses

Primary practice location

131 Bridge St
Naugatuck, CT 06770-2929

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1330

Other practice location 1

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180726000573 CT Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6901104330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

75 Holly Hill LN
Suite 201
Greenwich, CT 06830-2912
Phone (203) 869-6960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.6 of 100Reported as group
Quality
84.86
Promoting interoperability
99
Improvement activities
40
Cost
71.31

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
056412CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Stamford Health Medical Group Inc Internal Medicine CurrentSince Nov 6, 2023 Accepting new patients
Griffin Faculty Physicians, Inc. Internal Medicine CurrentSince Sep 30, 2018 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

130 Division St
Derby, CT 06418
Phone (203) 732-1330

67 Maple Ave
Derby, CT 06418
Phone (203) 732-0699

75 Holly Hill Ln
Greenwich, CT 06830
Phone (203) 661-3333

75 Holly Hill Ln
Ste 201
Greenwich, CT 06830
Phone (201) 357-8888

131 Bridge St
Naugatuck, CT 06770
Phone (203) 729-0755

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1386055069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 BRIDGE ST",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067702929",
            "telephone_number": "203-729-0755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Grant St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "06610",
            "country_code": "US",
            "telephone_number": "203-384-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE JESUS ROMAN",
        "first_name": "FELIX",
        "middle_name": "XAVIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "056412",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "56412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

Verify at the official NPI Registry.