Active NPI
Rom A Stevens, M.D.
- Critical Care Medicine (Internal Medicine) Physician
- Cudahy, WI
National Provider Identifier
1073596730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- 25448
- Practice address
- 5900 S Lake Dr
Cudahy, WI 53110-3171 - Phone
- (414) 489-9000
- NPI assigned
- Nov 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | 25448-020 | WI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 25448 | WI | Primary |
Addresses
Primary practice location
5900 S Lake Dr
Cudahy, WI 53110-3171
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (414) 489-9000
Other practice location 1
2901 W Kinnickinnic River Pkwy Ste 315
Milwaukee, WI 53215-3660
Phone (414) 649-5646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31779900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25448-020 | WI | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Cardiovascular Care, LLP | Past | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
-
- Cardiovascular Disease Physician
- Appleton, WI
- NPI 1740457217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1073596730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "414-489-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 S LAKE DR",
"city": "CUDAHY",
"state": "WI",
"postal_code": "531103171",
"telephone_number": "414-489-9000"
}
],
"practiceLocations": [
{
"address_1": "2901 W Kinnickinnic River Pkwy Ste 315",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532153660",
"country_code": "US",
"telephone_number": "414-649-5646",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEVENS",
"first_name": "ROM",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-26",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "WI",
"license": "25448-020",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "WI",
"license": "25448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31779900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cudahy, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.