Active NPI
Roman Becicka
- Child & Adolescent Psychiatry Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 71732
- Practice address
- 2450 Riverside Ave
Minneapolis, MN 55454-1450 - Phone
- (612) 672-6000
- NPI assigned
- Mar 11, 2015
- Last updated
- Aug 9, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Child & Adolescent Psychiatry Physician | 2084P0804X | 71732 | MN | Primary |
Addresses
Primary practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Mailing address
650 Ocean Ave Unit 738
Revere, MA 02151-1391
Other practice location 1
55 Fruit St Ste 815
Boston, MA 02114-2621
Phone (617) 726-2000
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71732 | MN | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients |
Locations
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273
45 10th St W
Ste 3000
Saint Paul, MN 55102
Phone (651) 232-3000
Interoperability endpoints
- rbecicka283086@direct.ochin.org
- rbecicka728189@fairview.direct-ci.com
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba M Health Fairview Recovery Clinic
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
dba HealthEast Vadnais Heights Clinic
- Clinic/Center
- Vadnais Heights, MN
- NPI 1639125503
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
dba Fairview Sleep Centers - Burnsville
- Family Medicine Physician
- Burnsville, MN
- NPI 1700258688
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
dba Fairview Emergency Medical Services
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
dba HealthEast Professional Services
- Internal Medicine Physician
- Saint Paul, MN
- NPI 1508191552
-
dba UMMC, Fairview (Psych Unit)
- Psychiatric Hospital Unit
- Minneapolis, MN
- NPI 1679121024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1083007322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 OCEAN AVE UNIT 738",
"city": "REVERE",
"state": "MA",
"postal_code": "021511391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "612-672-6000"
}
],
"practiceLocations": [
{
"address_1": "55 Fruit St Ste 815",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021142621",
"country_code": "US",
"telephone_number": "617-726-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BECICKA",
"first_name": "ROMAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-11",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MN",
"license": "71732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.