Individual provider Active NPI

Katerina Roma, DO

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1902301955
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO3472 Issued in NV
Practice address
2880 N Tenaya Way Ste 400
Las Vegas, NV 89128-0642
Phone
(702) 962-9550
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO3472 NV Primary

Addresses

Primary practice location

2880 N Tenaya Way Ste 400
Las Vegas, NV 89128-0642

Mailing address

PO Box 100744
Atlanta, GA 30384-2312

Other names 1

  • Katerina Eunhee Ko Other name

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO3472NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine Internal Medicine PastSince Apr 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1902301955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 N TENAYA WAY STE 400",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280642",
            "telephone_number": "702-962-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMA",
        "first_name": "KATERINA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO3472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATERINA",
            "last_name": "KO",
            "middle_name": "EUNHEE",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.