Individual provider Active NPI

Roger A. Marrero, MD

  • Family Medicine Physician
  • Oviedo, FL
National Provider Identifier
1871577338
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 0057713 Issued in FL
Practice address
1410 W Broadway St
Suite 108
Oviedo, FL 32765-6456
Phone
(407) 359-5098
Fax
(407) 365-5119
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 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 ME 0057713 FL Primary

Addresses

Primary practice location

1410 W Broadway St
Suite 108
Oviedo, FL 32765-6456

Mailing address

1410 W Broadway St
Suite 108
Oviedo, FL 32765-6456
Phone (407) 359-5098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110901000508 FL Practitioner - Family Practice 6305016205 Practice locations: Oviedo, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 0057713FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asa Health, Inc. Past Accepting new patients
Roger a. Marrero, M.D. Dba Oviedo Primary Care PastSince Feb 1, 1998 Accepting new patients

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1871577338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 W BROADWAY ST",
            "address_2": "SUITE 108",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656456",
            "telephone_number": "407-359-5098",
            "fax_number": "407-365-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W BROADWAY ST",
            "address_2": "SUITE 108",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656456",
            "telephone_number": "407-359-5098",
            "fax_number": "407-365-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "ROGER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 0057713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.