Individual provider Active NPI

Rosa C Roman, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bloomfield, NJ
National Provider Identifier
1720160567
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00191600 Issued in NJ
Practice address
977 Broad St
Bloomfield, NJ 07003-2821
Phone
(973) 338-1111
Fax
(973) 338-1119
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00191600 NJ Primary

Addresses

Primary practice location

977 Broad St
Bloomfield, NJ 07003-2821

Mailing address

977 Broad St
Bloomfield, NJ 07003-2821
Phone (973) 338-1111

Other identifiers 4

IdentifierTypeStateIssuer
1K7458OtherNJHEALTHNET
6200362OtherNJGHI
4560809MedicaidNJ
223116190OtherNJHORIZON BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100318000114 NJ Practitioner - Podiatry 7012042864 Practice locations: Bloomfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

977 Broad St
Bloomfield, NJ 07003-2821
Phone (973) 338-1111

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of skin lesions15
Removal of nail tissue326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: rosaroman@afcnj.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1720160567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032821",
            "telephone_number": "973-338-1111",
            "fax_number": "973-338-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032821",
            "telephone_number": "973-338-1111",
            "fax_number": "973-338-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "ROSA",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00191600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1K7458",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6200362",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4560809",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BC/BS",
            "identifier": "223116190",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.