Individual provider Active NPI

Gerard A Romaguera, MD

  • Family Medicine Physician
  • Gretna, LA
National Provider Identifier
1770691826
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
017334 Issued in LA
Practice address
316 Lafayette St
Gretna, LA 70053
Phone
(504) 391-0077
Fax
(504) 394-6827
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 017334 LA Primary

Addresses

Primary practice location

316 Lafayette St
Gretna, LA 70053

Mailing address

316 Lafayette St
Gretna, LA 70053
Phone (504) 391-0077

Other identifiers 1

IdentifierTypeStateIssuer
1339270MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041116000067 LA Practitioner - Family Practice 4688637192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

316 Lafayette St
Gretna, LA 70053-5932
Phone (504) 391-0077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17334LAMDPharmacist
017334LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
G a Romaguera MD LLC Family Medicine CurrentSince Oct 14, 1989 Accepting new patients
Functional Rehabilitation Center, LLC Past Accepting new patients

Locations

316 Lafayette St
Gretna, LA 70053
Phone (504) 391-0077

1581 Carol Sue Ave
Ste C
Terrytown, LA 70056
Phone (504) 391-0077

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1770691826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 LAFAYETTE ST",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "70053",
            "telephone_number": "504-391-0077",
            "fax_number": "504-394-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 LAFAYETTE ST",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "70053",
            "telephone_number": "504-391-0077",
            "fax_number": "504-394-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAGUERA",
        "first_name": "GERARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "017334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1339270",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.