Farid Roman (NPI# 1851366355, PAC ID# 3870574585) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ENDOCRINOLOGY.
| Nation Provider ID (NPI) | 1851366355 |
| PAC ID by PECOS | 3870574585 |
| Professional Enrollment ID | I20110330000166 |
| Full Name | Farid Roman |
| Organization Legal Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| Address |
11155 Dunn Rd 109 St Louis MO 63136-6150 |
| Phone Number | 3149538799 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1993 |
| Primary Specialty | ENDOCRINOLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 6800784083 |
| Number of Group Practice Members | 199 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260180 | CHRISTIAN HOSPITAL NORTHEAST |
| 140002 | ALTON MEMORIAL HOSPITAL |
| 140125 | GATEWAY REGIONAL MEDICAL CENTER |
| 140289 | ANDERSON HOSPITAL |
| 140185 | MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 155 E Bethalto Dr, Bethalto, IL 62010-1801 | 6186323343 | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| 8 Sunset Hills Professional Ctr, Edwardsville, IL 62025-3760 | 6186926109 | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| 11155 Dunn Rd 109, St Louis, MO 63136-6150 | 3149538799 | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| Organization Legal Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
| Physicians | 197 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica Lynn Riney | Nurse Practitioner | Fairview Heights Medical Group Sc | 2 Memorial Dr, Suite 220, Alton, IL 62002-6723 |
| Juletta Avagyan | Hospitalist | Fairview Heights Medical Group Sc | 1 Memorial Dr, Alton, IL 62002-6722 |
| Stanley Gooding | Nurse Practitioner | Fairview Heights Medical Group Sc | 5520 Godfrey Rd, B, Godfrey, IL 62035-2508 |
| Christine A Testa | Nurse Practitioner | Fairview Heights Medical Group Sc | 6810 State Route 162 102, Maryville, IL 62062-8560 |
| Supraja Reddy Reddy | Endocrinology | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Kristen N Massey | Nurse Practitioner | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
| Ann M Davis | Nurse Practitioner | Fairview Heights Medical Group Sc | 1225 Graham Rd, Suite 2310, Florissant, MO 63031-8023 |
| Guy W Aton | Internal Medicine | Fairview Heights Medical Group Sc | 3550 College Ave, B, Alton, IL 62002-5008 |
| Mattison Perez | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
| Lance L Lane | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
| Street Address |
11155 DUNN RD 109 |
| City | ST LOUIS |
| State | MO |
| Zip | 63136-6150 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Supraja Reddy Reddy | Endocrinology | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Kerri A Smith | Nurse Practitioner | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Rehana M Rafiq | Gastroenterology | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Susan Hofmann | Nurse Practitioner | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Olayiwola C Olagbegi | Gastroenterology | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Robert J Stoffa | Gastroenterology | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tanika C Mcclary | Nurse Practitioner | 10135 W Florissant Ave, Saint Louis, MO 63136-2103 | |
| Bhajan S Dara | Internal Medicine | Metro St Louis Renal Services Inc | 10160 W Florissant Ave, Suite 200, Saint Louis, MO 63136-2104 |
| Pradeep A Chandra | Cardiovascular Disease (cardiology) | St Louis Heart and Vascular PC | 2880 Netherton Dr, Suite 102, Saint Louis, MO 63136-4649 |
| Akinrinola Fatoki | Family Medicine | 2880 Netherton Dr, Suite 200, Saint Louis, MO 63136-4649 | |
| Reynal L Caldwell | General Practice | 2880 Netherton Dr, Suite 103, Saint Louis, MO 63136-4649 | |
| Meredith A Schoene | Nurse Practitioner | David J. Pernikoff, Md, PC | 2865 Netherton, St Louis, MO 63136-4674 |
| Juan O Carden | Hematology/oncology | 2865 Netherton Dr, Saint Louis, MO 63136-4674 | |
| Kamil Dostalik | Physical Therapy | Physical Therapy Consultants, Inc | 2865 Netherton Dr, Saint Louis, MO 63136-4674 |
| Steven M Mense | Physical Therapy | Physical Therapy Consultants, Inc | 2865 Netherton Dr, Saint Louis, MO 63136-4674 |
| Michael P Tuckey | Physical Therapy | Physical Therapy Consultants, Inc | 2865 Netherton Dr, Saint Louis, MO 63136-4674 |
| Find all physicians in zip 63136 | |||
| City | ST LOUIS |
| Zip Code | 63136 |
| Specialty | ENDOCRINOLOGY |
| City + Specialty | ST LOUIS + ENDOCRINOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.