Brick City Aesthetics LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

BRICK CITY AESTHETICS LLC

Doing business as

Brick City Aesthetics LLC

Practice address

328 S Bonaventure Ave Ste 2
Trinidad, CO 81082-2086

Phone

(719) 680-3509

NPI assigned

Feb 10, 2023

Organization subpart

No

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

Authorized official

Name

Dario Byung San Roman, NPNPI 1528462975

Title

Medical Director/Co-Owner

Phone

(719) 289-1139

Specialties & licenses 1

Addresses

Other names 1

• Brick City Aesthetics LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dario Byung San Roman, AGACNP/FNP

  • Family Nurse Practitioner
  • Trinidad, CO
  • NPI 1528462975
  NPD Authorized official

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1427755339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CORUNDUM RD",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810829413",
            "telephone_number": "719-680-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 S BONAVENTURE AVE STE 2",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822086",
            "telephone_number": "719-680-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRICK CITY AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "SAN ROMAN",
        "authorized_official_first_name": "DARIO",
        "authorized_official_middle_name": "BYUNG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/CO-OWNER",
        "authorized_official_telephone_number": "719-289-1139",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brick City Aesthetics LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Lee Blank, CRNA
• Steven David Blohm, DDS
• Valerie Jean Borsa, M.D.
• Marci Lee Bowers, MD
• Brian Scott DDS Ms PC
• Brandi Broaddus
• Katherine Marie Broman, M.D.
• Constance Brydges
• Arlyn D Bueno, PT
• Angela Kathryn Bumstead, D.C.

• Nurse Practitioner in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.