Individual provider Active NPI

Cindy Ann Roman, PA

  • Physician Assistant
  • Teaneck, NJ
National Provider Identifier
1982759536
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009976 Issued in NY
Practice address
718 Teaneck Rd.
Advanced Interventional Rad. Services @ Holy Name Med.
Teaneck, NJ 07666
Phone
(201) 227-6210
Fax
(201) 643-3077
NPI assigned
Jan 24, 2007
Last updated
Jun 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009976 NY Primary

Addresses

Primary practice location

718 Teaneck Rd.
Advanced Interventional Rad. Services @ Holy Name Med.
Teaneck, NJ 07666

Mailing address

718 Teaneck Rd
Advanced Interventional Rad. Services @ Holy Name Med.
Teaneck, NJ 07666-4245
Phone (201) 227-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120706000460 NJ Practitioner - Physician Assistant 0749445203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: cir9013@direct.nyp.org

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1982759536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "address_2": "ADVANCED INTERVENTIONAL RAD. SERVICES @ HOLY NAME MED.",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-227-6210",
            "fax_number": "201-643-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD.",
            "address_2": "ADVANCED INTERVENTIONAL RAD. SERVICES @ HOLY NAME MED.",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-227-6210",
            "fax_number": "201-643-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "CINDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.