Active NPI
Roman Aguon Salas, RN, NP, CNS
- Adult Health Nurse Practitioner
- Elmendorf AFB, AK
National Provider Identifier
1619865995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 95035330
- Practice address
- 5955 Zeamer Ave
Elmendorf AFB, AK 99506-3702 - Phone
- (907) 580-2778
- NPI assigned
- Jun 25, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Clinical Nurse Specialist | 364SA2200X | 5210 | CA | |
| Critical Care Medicine Clinical Nurse Specialist | 364SC0200X | 5210 | CA | |
| Gerontology Nurse Practitioner | 363LG0600X | 95035330 | CA | |
| Acute Care Clinical Nurse Specialist | 364SA2100X | 5210 | CA | |
| Gerontology Clinical Nurse Specialist | 364SG0600X | 5210 | CA | |
| Adult Health Nurse Practitioner | 363LA2200X | 95035330 | CA | Primary |
Addresses
Primary practice location
5955 Zeamer Ave
Elmendorf AFB, AK 99506-3702
Mailing address
11327 Fortino PT
San Diego, CA 92131-4229
Phone (619) 753-9015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Specialist, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95035330 | CA | MD | Gerontology Nurse Practitioner |
| 5210 | CA | MD | Adult Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750809600000",
"number": "1619865995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11327 FORTINO PT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921314229",
"telephone_number": "619-753-9015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE",
"city": "ELMENDORF AFB",
"state": "AK",
"postal_code": "995063702",
"telephone_number": "907-580-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALAS",
"first_name": "ROMAN",
"middle_name": "AGUON",
"credential": "RN, NP, CNS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-25",
"last_updated": "2025-06-25",
"certification_date": "2025-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "364SA2200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Adult Health",
"state": "CA",
"license": "5210",
"primary": false
},
{
"code": "364SC0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Critical Care Medicine",
"state": "CA",
"license": "5210",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95035330",
"primary": false
},
{
"code": "364SA2100X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Acute Care",
"state": "CA",
"license": "5210",
"primary": false
},
{
"code": "364SG0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Gerontology",
"state": "CA",
"license": "5210",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "95035330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elmendorf AFB, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.