Individual provider Active NPI

John Roman, JOHN ROMAN OTR/L

  • Occupational Therapist
  • Bronx, NY
National Provider Identifier
1790076123
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
016564 Issued in NY
Practice address
1039 E 241St St
Bronx, NY 10466-1040
Phone
(646) 335-2334
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 016564 NY Primary

Addresses

Primary practice location

1039 E 241St St
Bronx, NY 10466-1040

Mailing address

1857 Walton Ave
Apt 32a
Bronx, NY 10453-6230
Phone (347) 624-4581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1790076123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 WALTON AVE",
            "address_2": "APT 32A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536230",
            "telephone_number": "347-624-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 E 241ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104661040",
            "telephone_number": "646-335-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "JOHN",
        "credential": "JOHN ROMAN OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.