Individual provider Active NPI

Alejandro Pepen Romero, M.D.

  • Nephrology Physician
  • Freeport, NY
National Provider Identifier
1619257003
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME148284 Issued in FL
Practice address
55 N Main St
Freeport, NY 11520-2243
Phone
(163) 778-0145
NPI assigned
Aug 17, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 282309 NY
Nephrology Physician 207RN0300X ME148284 FL Primary

Addresses

Primary practice location

55 N Main St
Freeport, NY 11520-2243

Mailing address

PO Box 3877
Joliet, IL 60434-3877
Phone (815) 714-7149

Other identifiers 1

IdentifierTypeStateIssuer
110623200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210211001279 FL Practitioner - Nephrology 9436437449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

2501 Paul Buchman Hwy
Suite a
Plant City, FL 33563-9016
Phone (813) 910-0030

Hospital & facility affiliations

  • Kidney Center of Plant City LLC Dialysis facility, Plant City, FL, CCN 682700
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132
  • Adventhealth Riverview Hospital, Riverview, FL, CCN 100364
  • HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259
  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282309NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Jun 15, 2024 Accepting new patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Jun 15, 2024 Accepting new patients
Indi Vasudeva Services Inc Nephrology CurrentSince Feb 1, 2021 Accepting new patients
Tampa General Hospital Current Accepting new patients

Locations

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

2501 Paul Buchman Hwy
Ste A
Plant City, FL 33563

3140 S Falkenburg Rd
Ste 201
Riverview, FL 33578

946 Cypress Village Blvd
Ste A
Ruskin, FL 33573

2605 W Swann Ave
Ste 600
Tampa, FL 33609
Phone (813) 870-2528

1502 W Fletcher Ave
Ste 107
Tampa, FL 33612
Phone (813) 549-2392

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: apepenromero199530@direct.tgh.org
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: alejandro.pepen.romero.1@15644.direct.athenahealth.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 and National Provider Directory roles.

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": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1619257003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3877",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604343877",
            "telephone_number": "815-714-7149",
            "fax_number": "815-435-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N MAIN ST",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202243",
            "telephone_number": "163-778-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPEN ROMERO",
        "first_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "282309",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME148284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110623200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.