Roman P Smulka, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27033 Issued in MN

Practice address

15245 Bluebird St NW
Mail Stop 39200a Riverway Clinic - Andover
Andover, MN 55304-3554

Phone

(763) 587-4600

Fax

(763) 587-4615

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Group Health, Inc.

  dba HealthPartners Medical Group

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  dba HealthPartners Riverside Dental Clinic

  • Pediatric Dentistry
  • Minneapolis, MN
  • NPI 1700932449
  NPD
• Group Health, Inc.

  dba HealthPartners Midway Residency Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1043284268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553043538",
            "telephone_number": "763-587-4600",
            "fax_number": "763-587-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "address_2": "MAIL STOP 39200A RIVERWAY CLINIC - ANDOVER",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043554",
            "telephone_number": "763-587-4600",
            "fax_number": "763-587-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMULKA",
        "first_name": "ROMAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "27033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668585400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey E Smith, OD
• Jodi Ann Smith, M.S., LMFT
• Joshua Smith, DPT
• Tamara Smith, D.D.S., M.S.D
• Hannah Smoker, DPT
• Laura Snell, M.A., OTR/L
• Sarah Sneltjes, DPT
• Kayla Evelyn Sorlie
• Sozo Recovery Care
• Steadfast Senior Care (Home Instead)

• Family Medicine Physician in Andover, MN
• Providers in Andover, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.