Active NPI
Dawn Carroll Roman, PA-C
- Surgical Physician Assistant
- Joliet, IL
National Provider Identifier
1831199587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 085000381
- Practice address
- 1051 Essington Rd
Suite 280
Joliet, IL 60435-2801 - Phone
- (815) 744-8554
- Fax
- (815) 744-3969
- NPI assigned
- Jul 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 10000242A | IN | |
| Surgical Physician Assistant | 363AS0400X | 085000381 | IL | Primary |
Addresses
Primary practice location
1051 Essington Rd
Suite 280
Joliet, IL 60435-2801
Mailing address
820 Springer Dr
Lombard, IL 60148-6413
Phone (815) 744-8554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01618941 | Other | IL | BC/BS |
Other names 1
- Ms. Dawn Carroll Gerchar
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10000242A | IN | MD | Surgical Physician Assistant |
Interoperability endpoints
- droman@directaddress.net
- dawn.roman.1@3342.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1831199587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 SPRINGER DR",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601486413",
"telephone_number": "815-744-8554",
"fax_number": "630-495-1770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 ESSINGTON RD",
"address_2": "SUITE 280",
"city": "JOLIET",
"state": "IL",
"postal_code": "604352801",
"telephone_number": "815-744-8554",
"fax_number": "815-744-3969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "DAWN",
"middle_name": "CARROLL",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-22",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IN",
"license": "10000242A",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "085000381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "01618941",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DAWN",
"last_name": "GERCHAR",
"middle_name": "CARROLL",
"prefix": "MS.",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.