Individual provider Active NPI

Romeo Miraflor Pineda Jr., M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Olathe, KS
National Provider Identifier
1700920832
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
0436606 Issued in KS
Practice address
407 S Clairborne Rd Ste 200
Olathe, KS 66062-1744
Phone
(913) 839-3139
Fax
(913) 839-3190
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 0436606 KS Primary
General Practice Physician 208D00000X 0436606 KS

Addresses

Primary practice location

407 S Clairborne Rd Ste 200
Olathe, KS 66062-1744

Mailing address

407 S Clairborne Rd Ste 200
Olathe, KS 66062-1744
Phone (913) 839-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20151208000140 KS Practitioner - Addiction Medicine 4981738556 Practice locations: Olathe, KS

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 S Clairborne Rd
Suite 200
Olathe, KS 66062-1744
Phone (913) 839-3139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0436606KSMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Provider Health Services PastSince May 7, 2014 Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24447/brand/1/csg/1/fhir/r4

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1700920832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S CLAIRBORNE RD STE 200",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621744",
            "telephone_number": "913-839-3139",
            "fax_number": "913-839-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S CLAIRBORNE RD STE 200",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621744",
            "telephone_number": "913-839-3139",
            "fax_number": "913-839-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "ROMEO",
        "middle_name": "MIRAFLOR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KS",
            "license": "0436606",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "0436606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.