Individual provider Active NPI

Paul B Roemer, MD

  • Internal Medicine Physician
  • Du Bois, PA
National Provider Identifier
1548360928
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD067947L Issued in PA
Practice address
211 Beaver Dr
Du Bois, PA 15801-2517
Phone
(814) 375-9383
Fax
(814) 375-9390
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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 MD067947L PA Primary

Addresses

Primary practice location

211 Beaver Dr
Du Bois, PA 15801-2517

Mailing address

759 Lincoln Dr
Du Bois, PA 15801-3473
Phone (814) 599-8584

Other identifiers 1

IdentifierTypeStateIssuer
001765984 0008MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20051221000534 PA Practitioner - Internal MedicinePractitioner - Addiction Medicine 0244252088 Practice locations: Du Bois, PA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD067947LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients
Summit BHC Westfield, 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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1548360928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 LINCOLN DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158013473",
            "telephone_number": "814-599-8584",
            "fax_number": "814-375-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BEAVER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012517",
            "telephone_number": "814-375-9383",
            "fax_number": "814-375-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEMER",
        "first_name": "PAUL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD067947L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001765984 0008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.