Individual provider Active NPI

Lorenzo Perez Romano, MD

  • Pediatrics Physician
  • Portage, WI
National Provider Identifier
1770939233
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
71827 Issued in WI
Practice address
2817 New Pinery Rd
Portage, WI 53901-9240
Phone
(608) 742-4131
NPI assigned
May 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 71827 WI Primary

Addresses

Primary practice location

2817 New Pinery Rd
Portage, WI 53901-9240

Mailing address

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Other practice location 1

Puerto Rico Medical Center
Bo. Monacillos
San Juan, PR 00917
Phone (787) 480-2791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20191009000527 WI Practitioner - Pediatric Medicine 4385975168 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71827WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Savior Healthcare, Inc. CurrentSince Oct 21, 2019 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Oct 21, 2019 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

419 N Oak St
Adams, WI 53910
Phone (608) 339-5250

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • Direct secure messaging: sjclperezr@yourcarecommunity.org
  • Direct secure messaging: lperezromano159993@direct.aspirus.org

Organizations & group practices 5

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": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1770939233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Puerto Rico Medical Center",
            "address_2": "Bo. Monacillos",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00917",
            "country_code": "US",
            "telephone_number": "787-480-2791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ ROMANO",
        "first_name": "LORENZO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "71827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

Verify at the official NPI Registry.