Individual provider Active NPI

Roman A Shulze, D.O.

  • Occupational Medicine Physician
  • Anaheim, CA
National Provider Identifier
1679667182
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
20A8047 Issued in CA
Practice address
1717 E Lincoln Ave
Anaheim, CA 92805-4345
Phone
(714) 635-2642
Fax
(714) 635-8547
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8047 CA
Occupational Medicine Physician 2083X0100X 20A8047 CA Primary

Addresses

Primary practice location

1717 E Lincoln Ave
Anaheim, CA 92805-4345

Mailing address

16702 Valley View Ave
La Mirada, CA 90638-5824
Phone (714) 367-5360

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150817000100 CA Practitioner - Family Practice 5092702332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthpointe Medical Group, Inc.Group PAC ID 0941299135, shared by 2 NPIs, 35 clinicians

Practice addresses (Care Compare)

1717 E Lincoln Ave
Anaheim, CA 92805-4345
Phone (714) 635-2642

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8047CAMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpointe Medical Group, Inc. CurrentSince Jun 1, 2015 Accepting new patients
Healthpointe Medical Group, Inc. Current Accepting new patients

Locations

1717 E Lincoln Ave
Anaheim, CA 92805
Phone (714) 635-2642

16702 Valley View Ave
La Mirada, CA 90638
Phone (562) 921-0341

754 N Mountain Ave
Ontario, CA 91762
Phone (909) 460-4155

Organizations & group practices 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679667182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16702 VALLEY VIEW AVE",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906385824",
            "telephone_number": "714-367-5360",
            "fax_number": "714-635-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054345",
            "telephone_number": "714-635-2642",
            "fax_number": "714-635-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULZE",
        "first_name": "ROMAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8047",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "20A8047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.