NPIMap

Organization Active NPI

Romagosa Dermatology Group LLC

  • Dermatology Physician
  • Stuart, FL
National Provider Identifier
1609863398
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME85844 Issued in FL
Legal business name
ROMAGOSA DERMATOLOGY GROUP LLC
Practice address
2220 SE Ocean Blvd
Suite 301
Stuart, FL 34996-2364
Phone
(772) 220-3339
Fax
(772) 286-2635
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Authorized official

Name
Mr. Ricardo Antonio Romagosa, M.D.NPI 1720075401
Title
Managing Member
Phone
(772) 220-3339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME85844 FL Primary

Addresses

Primary practice location

2220 SE Ocean Blvd
Suite 301
Stuart, FL 34996-2364

Mailing address

2220 SE Ocean Blvd
Suite 301
Stuart, FL 34996-2364
Phone (772) 220-3339

Other identifiers 1

IdentifierTypeStateIssuer
79738OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050914001230 FL Part B Supplier - Clinic/Group Practice 8022041565 Receives reassigned benefits from 12 practitioners
Practice locations: Port St Lucie, FL; Stuart, FL

National Provider Directory

National Provider Directory

Locations

2220 SE Ocean Blvd
Ste 302
Stuart, FL 34996
Phone (772) 220-3339

2220 SE Ocean Blvd
Ste 102
Stuart, FL 34996
Phone (772) 220-3339

2220 SE Ocean Blvd
Ste 301
Stuart, FL 34996
Phone (772) 220-3339

2220 SE Ocean Blvd
Ste 204
Stuart, FL 34996
Phone (772) 220-3339

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236902400000",
    "number": "1609863398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 SE OCEAN BLVD",
            "address_2": "SUITE 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349962364",
            "telephone_number": "772-220-3339",
            "fax_number": "772-286-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 SE OCEAN BLVD",
            "address_2": "SUITE 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349962364",
            "telephone_number": "772-220-3339",
            "fax_number": "772-286-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMAGOSA DERMATOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-03-13",
        "status": "A",
        "authorized_official_last_name": "ROMAGOSA",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "772-220-3339",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME85844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "79738",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.