Active NPI
Real Medcare LLC
- Gerontology Nurse Practitioner
- Fulshear, TX
National Provider Identifier
1962977553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- Legal business name
- REAL MEDCARE LLC
- Practice address
- 3935 Banks Landing CT
Fulshear, TX 77441-4553 - Phone
- (954) 665-7258
- NPI assigned
- Oct 10, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Martiza Romero
- Title
- NP
- Phone
- (954) 665-7258
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | |||
| Gerontology Nurse Practitioner | 363LG0600X | Primary |
Addresses
Primary practice location
3935 Banks Landing CT
Fulshear, TX 77441-4553
Mailing address
3935 Banks Landing CT
Fulshear, TX 77441-4553
Phone (954) 665-7258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181121002476 | TX | Part B Supplier - Clinic/Group Practice | 6002160488 |
Receives reassigned benefits from 1 practitioner Practice locations: Fulshear, TX |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713225600000",
"number": "1962977553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3935 BANKS LANDING CT",
"city": "FULSHEAR",
"state": "TX",
"postal_code": "774414553",
"telephone_number": "954-665-7258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3935 BANKS LANDING CT",
"city": "FULSHEAR",
"state": "TX",
"postal_code": "774414553",
"telephone_number": "954-665-7258"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REAL MEDCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-10",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A",
"authorized_official_last_name": "ROMERO",
"authorized_official_first_name": "MARTIZA",
"authorized_official_title_or_position": "NP",
"authorized_official_telephone_number": "954-665-7258"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fulshear, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.