Individual provider Active NPI

John W Roman, M.D.

  • Dermatology Physician
  • Norfolk, VA
National Provider Identifier
1700148277
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101254438 Issued in VA
Practice address
885 Kempsville Rd Ste 309
Norfolk, VA 23502-3800
Phone
(757) 347-2712
Fax
(757) 502-8933
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 20101 NH
Dermatology Physician 207N00000X 0101254438 VA Primary

Addresses

Primary practice location

885 Kempsville Rd Ste 309
Norfolk, VA 23502-3800

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 948-0291

Other practice location 1

8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone (540) 842-2553

Other practice location 2

355 Crawford St Ste 622
Portsmouth, VA 23704-2823
Phone (757) 399-8456

Other practice location 3

733 Volvo Pkwy Ste 300
Chesapeake, VA 23320-1610
Phone (757) 461-1103

Other practice location 4

590 Court St
Keene, NH 03431-1719
Phone (603) 653-2066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260424002056 VA Practitioner - Dermatology 0244668770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Dermatology of Tidewater LLCGroup PAC ID 8325277031, 9 clinicians

Practice addresses (Care Compare)

355 Crawford St
Suite 622
Portsmouth, VA 23704-2823
Phone (757) 347-2712

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101254438VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Tidewater LLC Dermatology CurrentSince Mar 1, 2026 Accepting new patients
On Site Dermatology LLC Dermatology CurrentSince Mar 1, 2026 Accepting new patients

Locations

4700 Exchange Ct
Ste 110
Boca Raton, FL 33431
Phone (561) 223-8081

733 Volvo Pkwy
Ste 300
Chesapeake, VA 23320
Phone (757) 321-3383

885 Kempsville Rd
Ste 309
Norfolk, VA 23502
Phone (757) 347-2712

355 Crawford St
Ste 622
Portsmouth, VA 23704
Phone (757) 347-2712

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1700148277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 KEMPSVILLE RD STE 309",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023800",
            "telephone_number": "757-347-2712",
            "fax_number": "757-502-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890004",
            "country_code": "US",
            "telephone_number": "540-842-2553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "355 Crawford St Ste 622",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237042823",
            "country_code": "US",
            "telephone_number": "757-399-8456",
            "fax_number": "757-502-8933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "733 Volvo Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233201610",
            "country_code": "US",
            "telephone_number": "757-461-1103",
            "fax_number": "757-502-8933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "590 Court St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034311719",
            "country_code": "US",
            "telephone_number": "603-653-2066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "20101",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101254438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.