Emily Destefano Roman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003217 Issued in CT

Practice address

1300 Post Rd
Suite 202
Fairfield, CT 06824-6038

Phone

(203) 255-8827

Fax

(203) 259-4610

NPI assigned

Oct 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairfield Medical Group, LLCGroup PAC ID 5597654343, 5 clinicians

St. Vincents Urgent Care LLCGroup PAC ID 6901119767, 43 clinicians

Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eroman132965@direct.ynhh.org
• Direct secure messaging: eroman509103@xdr.hhchealthdirect.org

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.

• Fairfield Medical Group, LLC

  • Internal Medicine Physician
  • Fairfield, CT
  • NPI 1013098839
  Medicare reassignment Care Compare group
• St. Vincents Urgent Care LLC

  • Urgent Care Clinic/Center
  • Fairfield, CT
  • NPI 1912305483
  Medicare reassignment Care Compare group
• QMG2,LLC

  • Urgent Care Clinic/Center
  • Fairfield, CT
  • NPI 1437546363
  Medicare reassignment
• QMG3, LLC

  • Urgent Care Clinic/Center
  • Shelton, CT
  • NPI 1053856039
  Medicare reassignment
• QMG4, LLC

  • Family Medicine Physician
  • Bridgeport, CT
  • NPI 1023471299
  Medicare reassignment
• QMG5,LLC

  • Urgent Care Clinic/Center
  • Trumbull, CT
  • NPI 1386233344
  Medicare reassignment
• Quentin Medical Group, LLC

  • Urgent Care Clinic/Center
  • Bridgeport, CT
  • NPI 1487087250
  Medicare reassignment
• St. Vincents Urgent Care LLC

  • Internal Medicine Physician
  • Trumbull, CT
  • NPI 1043852569
  NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  NPD (past)
• QMG7,LLC

  • Urgent Care Clinic/Center
  • New Haven, CT
  • NPI 1487367199
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1700280146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 POST RD",
            "address_2": "SUITE 202",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246038",
            "telephone_number": "203-255-8827",
            "fax_number": "203-259-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 POST RD",
            "address_2": "SUITE 202",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246038",
            "telephone_number": "203-255-8827",
            "fax_number": "203-259-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "EMILY",
        "middle_name": "DESTEFANO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Roberts, MS, CCC-SLP
• Skylar Krystina Robinson
• Rockwell Pediatrics, PLLC
• Ludmila M Rodrigues
• Sol L Rodriguez-Ference, DVM
• Kathryn Jo Roman, OTR/L
• Joseph Michael Romanelli, DDS
• Amanda D Romaniello, LPC
• Mark Joesph Romano, ND
• Wendy Romney, DPT

• Physician Assistant in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.