Individual provider Active NPI

Christopher Stephen Roman, D.O.

  • Emergency Medicine Physician
  • Callicoon, NY
National Provider Identifier
1558564310
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
260718 Issued in NY
Practice address
8881 State Route 97
Callicoon, NY 12723-5052
Phone
(845) 887-5693
Fax
(845) 887-5694
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102201922 VA
Emergency Medicine Physician 207P00000X 260718 NY Primary

Addresses

Primary practice location

8881 State Route 97
Callicoon, NY 12723-5052

Mailing address

8881 State Route 97
Callicoon, NY 12723-5052
Phone (845) 887-5693

Other practice location 1

38 Concord Rd
Monticello, NY 12701-3210
Phone (845) 333-6500

Other identifiers 1

IdentifierTypeStateIssuer
03472502MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address croman34458@direct.garnethealth.org Direct Garnet Health Doctors PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120627000205 NY Practitioner - Emergency Medicine 1850556754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians

Practice addresses (Care Compare)

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102201922VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Dec 20, 2021 Accepting new patients
Middletown Medical PC Emergency Medicine CurrentSince Dec 20, 2021 Accepting new patients
Sullivan Emergency Services PC Emergency Medicine CurrentSince Feb 15, 2015 Accepting new patients

Locations

8881 State Route 97
Callicoon, NY 12723
Phone (845) 333-6800

111 Maltese Dr
Middletown, NY 10940

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: croman34458@direct.garnethealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1558564310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8881 STATE ROUTE 97",
            "city": "CALLICOON",
            "state": "NY",
            "postal_code": "127235052",
            "telephone_number": "845-887-5693",
            "fax_number": "845-887-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 STATE ROUTE 97",
            "city": "CALLICOON",
            "state": "NY",
            "postal_code": "127235052",
            "telephone_number": "845-887-5693",
            "fax_number": "845-887-5694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38 Concord Rd",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "NY",
            "postal_code": "127013210",
            "country_code": "US",
            "telephone_number": "845-333-6500",
            "fax_number": "845-333-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102201922",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "260718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03472502",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "croman34458@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8881 State Route 97",
            "city": "Callicoon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "127235052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Callicoon, NY

Sources for this page

Verify at the official NPI Registry.