Individual provider Active NPI

Angela Mae G Roman, NP

  • Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1992360036
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95009903 Issued in CA
Practice address
625 S Fair Oaks Ave Ste 215
Pasadena, CA 91105-2613
Phone
(626) 793-4139
Fax
(626) 793-4324
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95009903 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 215
Pasadena, CA 91105-2613

Mailing address

PO Box 80011
City of Industry, CA 91716-8011
Phone (626) 793-2885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729001222 CA Practitioner - Nurse Practitioner 1557807385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009903CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothill Cardiology Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients
Huntington Geriatric Medical Group PastSince Oct 1, 2007 Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Locations

625 S Fair Oaks Ave
Ste 215
Pasadena, CA 91105
Phone (626) 793-4139

Interoperability endpoints

  • Direct secure messaging: angela.roman.p166@direct.healthcarepartners.nextgenshare.com

Organizations & group practices 3

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": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1992360036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80011",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168011",
            "telephone_number": "626-793-2885",
            "fax_number": "626-793-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 215",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052613",
            "telephone_number": "626-793-4139",
            "fax_number": "626-793-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "ANGELA MAE",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.