Marialba Romero Medina, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

4301114454 Issued in MI

Practice address

1001 S Raisinville Rd
Monroe, MI 48161

Phone

(800) 886-7340

NPI assigned

Sep 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other names 1

• Dr. Marialba Romero Medina Professional name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Independence Health & Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodstock, IL
  • NPI 1598717597
  Medicare reassignment NPD
• Independence Health & Therapy

  • Public Health or Welfare Agency
  • Woodstock, IL
  • NPI 1184744625
  NPD
• Aura Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
  • NPI 1386390235

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1407040173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100256",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100256",
            "telephone_number": "352-294-4900",
            "fax_number": "352-392-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S RAISINVILLE RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "48161",
            "telephone_number": "800-886-7340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-294-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "352-294-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10127 Morocco St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782163943",
            "country_code": "US",
            "telephone_number": "469-599-2872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485925",
            "country_code": "US",
            "telephone_number": "352-294-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMERO MEDINA",
        "first_name": "MARIALBA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME135535",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "11808 I",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME135535",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036156036",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "17882",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036156036",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301114454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIALBA",
            "last_name": "ROMERO MEDINA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tyson J Roethlisberger, D.D.S.
• Teresa Roggow
• Haley Rohde, MS
• Ashley Rohr
• Leslie Anne Rohr, LMSW
• Yasmyne Ronquillo, M.D.
• Alexandria Root
• Dayna Root
• Ashlyn Riley Rose
• Justin Rothman

• Child & Adolescent Psychiatry Physician in Monroe, MI
• Providers in Monroe, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.