Individual provider Active NPI

Richard Alexander Romero, PA-C

  • Physician Assistant
  • Santa Ana, CA
National Provider Identifier
1598522849
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64581 Issued in CA
Practice address
1206 E 17TH St
Santa Ana, CA 92701-2641
Phone
(714) 352-2911
Fax
(714) 352-2903
NPI assigned
Mar 4, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 PA64581 CA Primary

Addresses

Primary practice location

1206 E 17TH St
Santa Ana, CA 92701-2641

Mailing address

1021 Sierra Vista Dr
La Habra, CA 90631-2767
Phone (562) 501-8829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240821000738 CA Practitioner - Physician Assistant 6103364104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA64581CAMDPhysician Assistant

Organizations & group practices 1

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": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1598522849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 SIERRA VISTA DR",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906312767",
            "telephone_number": "562-501-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911",
            "fax_number": "714-352-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "RICHARD",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.