Individual provider Active NPI

Christopher Thomas Roman, PA-C

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1407155690
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001249A Issued in IN
Practice address
11455 N. Meridian Street
Suite 200
Carmel, IN 46032-1680
Phone
(317) 582-8180
Fax
(317) 582-8185
NPI assigned
Mar 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001249A IN Primary

Addresses

Primary practice location

11455 N. Meridian Street
Suite 200
Carmel, IN 46032-1680

Mailing address

12302 Hancock St
Carmel, IN 46032-5807
Phone (317) 564-4836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111003000195 IN Practitioner - Physician Assistant 6002088762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pike Medical Consultants PCGroup PAC ID 1850495003, 25 clinicians

Practice addresses (Care Compare)

762 N Dan Jones Rd
Gericare Indy
Avon, IN 46123-6213
Phone (317) 956-6288

7911 Michigan Rd
Indianapolis, IN 46268-1915

7911 N Michigan Rd
Indianapolis, IN 46268-1915
Phone (317) 956-6288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001249AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1407155690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12302 HANCOCK ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325807",
            "telephone_number": "317-564-4836",
            "fax_number": "317-587-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11455 N. MERIDIAN STREET",
            "address_2": "SUITE 200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321680",
            "telephone_number": "317-582-8180",
            "fax_number": "317-582-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001249A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.