Active NPI
Diana Roman
- Internal Medicine Physician
- New Brunswick, NJ
National Provider Identifier
1629024922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MA0601860
- Practice address
- 46 Bayard St
Suite 405
New Brunswick, NJ 08901-2152 - Phone
- (732) 247-1106
- Fax
- (732) 247-1124
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MA0601860 | NJ | Primary |
| Internal Medicine Physician | 207R00000X | 25MA07628900 | NJ |
Addresses
Primary practice location
46 Bayard St
Suite 405
New Brunswick, NJ 08901-2152
Mailing address
134 Evergreen Place
701
East Orange, NJ 07018
Phone (973) 395-3701
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116427 | Other | NJ | MEDICARE PROVIDER |
| 0107140 | Medicaid | NJ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA0601860 | NJ | MD | Internal Medicine Physician |
| 25MA07628900 | NJ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210377600000",
"number": "1629024922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 EVERGREEN PLACE",
"address_2": "701",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "07018",
"telephone_number": "973-395-3701",
"fax_number": "732-247-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 BAYARD ST",
"address_2": "SUITE 405",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089012152",
"telephone_number": "732-247-1106",
"fax_number": "732-247-1124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "DIANA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2008-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA0601860",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA07628900",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER",
"identifier": "116427",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0107140",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.