Individual provider Active NPI

Matthew Antoni Roman, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1558649061
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD452451 Issued in PA
Practice address
131 N 4TH St
Philadelphia, PA 19106-1995
Phone
(844) 472-9333
Fax
(855) 696-3299
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD452451 PA Primary
Internal Medicine Physician 207R00000X C1-0011364 DE

Addresses

Primary practice location

131 N 4TH St
Philadelphia, PA 19106-1995

Mailing address

1224 N King St
Wilmington, DE 19801-3232
Phone (855) 420-3627

Other practice location 1

1224 N King St
Wilmington, DE 19801-3232
Phone (855) 420-3627

Other practice location 2

3431 Argyle Ave
Erie, PA 16505-1804
Phone (412) 334-7600

Other practice location 3

1224 N King St
Wilmington, DE 19801-3232
Phone (855) 420-3627

Other identifiers 2

IdentifierTypeStateIssuer
C1-0011364OtherDEDE LICENCE
MD452451OtherPAMEDICAL LICENSE

Other names 1

  • Mateusz Antoni Roman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140805000109 PA Practitioner - Internal Medicine 1456578111 Reassigns benefits to 1 organization
I20240127000474 DE Practitioner - Internal Medicine 1456578111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice Associates, PAGroup PAC ID 7012985641, 7 clinicians

Practice addresses (Care Compare)

1100 S Broom St
Wilmington, DE 19805-4585
Phone (302) 656-5416

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0011364DEMDInternal Medicine Physician
MD452451PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Community Health Care, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Family Practice Associates, PA CurrentSince Dec 19, 2023 Accepting new patients
Natures Way Medicine Internal Medicine PastSince Jan 12, 2020 Accepting new patients
Natures Way Medicine Past Accepting new patients

Locations

1100 S Broom St
Wilmington, DE 19805
Phone (302) 510-4302

2501 W Lehigh Ave
Philadelphia, PA 19132
Phone (215) 227-0300

Interoperability endpoints

  • Direct secure messaging: matthew.roman@118277986320388.direct.elationemr.com

Organizations & group practices 4

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 7

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558649061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 N KING ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198013232",
            "telephone_number": "855-420-3627",
            "fax_number": "855-696-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 N 4TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061995",
            "telephone_number": "844-472-9333",
            "fax_number": "855-696-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1224 N King St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198013232",
            "country_code": "US",
            "telephone_number": "855-420-3627",
            "fax_number": "855-696-3299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3431 Argyle Ave",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165051804",
            "country_code": "US",
            "telephone_number": "412-334-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1224 N King St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198013232",
            "country_code": "US",
            "telephone_number": "855-420-3627",
            "fax_number": "855-696-3299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "MATTHEW",
        "middle_name": "ANTONI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD452451",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0011364",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DE LICENCE",
            "identifier": "C1-0011364",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD452451",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATEUSZ",
            "last_name": "ROMAN",
            "middle_name": "ANTONI",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.