Individual provider Active NPI

Michael Emilio Romero, D.O.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1386936862
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A11464 Issued in CA
Practice address
1200 N State St
Ird Room 624
Los Angeles, CA 90033-1029
Phone
(323) 226-7556
NPI assigned
May 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A11464 CA Primary

Addresses

Primary practice location

1200 N State St
Ird Room 624
Los Angeles, CA 90033-1029

Mailing address

5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone (619) 461-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20121024000736 CA Practitioner - Internal Medicine 8325298532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Diego Critical Care Medical Group IncGroup PAC ID 7911083886, 74 clinicians
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 461-1920

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11464CAMDAcupuncturist
20A11464CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Critical Care Medical Group, Inc Internal Medicine CurrentSince Sep 3, 2012 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 18, 2014 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1386936862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-461-1920",
            "fax_number": "619-461-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "IRD ROOM 624",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "MICHAEL",
        "middle_name": "EMILIO",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.