Individual provider Active NPI

Komal Romance, MD

  • Student in an Organized Health Care Education/Training Program
  • East Norriton, PA
National Provider Identifier
1740036029
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
21058 Issued in ND
Practice address
2705 Dekalb Pike Ste 202
East Norriton, PA 19401-1852
Phone
(610) 275-7240
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 21058 ND Primary

Addresses

Primary practice location

2705 Dekalb Pike Ste 202
East Norriton, PA 19401-1852

Mailing address

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 234-5933

Other practice location 1

5225 23rd Ave S
Fargo, ND 58104-7927
Phone (701) 234-5933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251028002234 PA Order and Referring Only - Family PracticePractitioner - Family Practice 0749779072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21058NDMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1740036029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 23RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047927",
            "telephone_number": "701-234-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 DEKALB PIKE STE 202",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194011852",
            "telephone_number": "610-275-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581047927",
            "country_code": "US",
            "telephone_number": "701-234-5933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMANCE",
        "first_name": "KOMAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ND",
            "license": "21058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Norriton, PA

Sources for this page

Verify at the official NPI Registry.