Individual provider Active NPI

Janis Elizabeth Romanik, D.O.

  • Addiction Medicine (Family Medicine) Physician
  • Washington TWP, MI
National Provider Identifier
1023234200
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
5101016195 Issued in MI
Practice address
12150 30 Mile Rd
Suite 201
Washington TWP, MI 48095-2035
Phone
(586) 336-2380
Fax
(586) 336-2381
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101016195 MI
General Practice Physician 208D00000X 5101016195 MI
Addiction Medicine (Family Medicine) Physician 207QA0401X 5101016195 MI Primary

Addresses

Primary practice location

12150 30 Mile Rd
Suite 201
Washington TWP, MI 48095-2035

Mailing address

400 Stoddard Rd
Richmond, MI 48062-2505
Phone (248) 658-1116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000553 MI Practitioner - Family Practice 3173687001 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101016195MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Rehabilitation Center, Inc. Current Accepting new patients
Henry Ford Macomb Hospital Corporation Family Medicine CurrentSince Dec 1, 2008 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Dec 1, 2008 Accepting new patients
Henry Ford Macomb Hospital Corporation Family Medicine Current Accepting new patients
Sacred Heart Rehabilitation Center, Inc. Past Accepting new patients

Locations

80650 Van Dyke Rd
Bruce Twp, MI 48065
Phone (810) 798-6410

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

2091 Professional Dr
Flint, MI 48532
Phone (810) 732-1652

28303 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 439-1759

1406 8th St
Port Huron, MI 48060
Phone 8109871258 ext. 5529

400 Stoddard Rd
Richmond, MI 48062

19611 E 8 Mile Rd
St Clr Shores, MI 48080
Phone (586) 541-9550

12150 30 Mile Rd
Ste 201
Washington Twp, MI 48095
Phone (586) 336-2380

Organizations & group practices 5

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1023234200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STODDARD RD",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480622505",
            "telephone_number": "248-658-1116",
            "fax_number": "248-658-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 30 MILE RD",
            "address_2": "SUITE 201",
            "city": "WASHINGTON TWP",
            "state": "MI",
            "postal_code": "480952035",
            "telephone_number": "586-336-2380",
            "fax_number": "586-336-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANIK",
        "first_name": "JANIS",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016195",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101016195",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "5101016195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington TWP, MI

Sources for this page

Verify at the official NPI Registry.