Individual provider Active NPI

Amarilis Roman, PA-C

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1891629895
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA067620 Issued in PA
Practice address
17520 Hillside Ave Ste 200
Jamaica, NY 11432-5773
Phone
(917) 396-0747
NPI assigned
Jun 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA067620 PA Primary
Medical Physician Assistant 363AM0700X 036297 NY

Addresses

Primary practice location

17520 Hillside Ave Ste 200
Jamaica, NY 11432-5773

Mailing address

119 Jerome St
Brooklyn, NY 11207-2705

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1891629895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 JEROME ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17520 HILLSIDE AVE STE 200",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325773",
            "telephone_number": "917-396-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "AMARILIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA067620",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "036297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.