Terry Mark Roman, D.O.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

54555-021 Issued in WI

Practice address

123 Hospital Dr
Suite 1008
Watertown, WI 53098-3331

Phone

(920) 206-6500

Fax

(920) 261-4013

NPI assigned

Nov 15, 2007

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 WI

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

Specialty

Orthopedic Surgery

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary's Hospital - Janesville Hospital, Janesville, WI, CCN 520208
• Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071
• The Monroe Clinic Hospital, Monroe, WI, CCN 520028
• SSM Health St Mary's Hospital - Madison Hospital, Madison, WI, CCN 520083

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: troman517142@direct-ehr-ssmhc.com

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.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Watertown Physician Practices LLC

  • Family Medicine Physician
  • Watertown, WI
  • NPI 1770964363
  Medicare reassignment NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD
• Watertown Physician Practices LLC

  • Obstetrics & Gynecology Physician
  • Watertown, WI
  • NPI 1225412265
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Hospital

  Care Compare affiliation
• Fort Healthcare, Inc.

  • General Acute Care Hospital
  • Fort Atkinson, WI
  • NPI 1811916281
  Care Compare affiliation
• SSM Health Care of Wisconsin, Inc.

  dba SSM Health St. Mary's Hospital-Madison

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1184621211
  Care Compare affiliation
• SSM Health Care of Wisconsin, Inc.

  dba SSM Health St. Mary's Hospital - Janesville

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1194004408
  Care Compare affiliation
• The Monroe Clinic, Inc.

  dba SSM Health Monroe Hospital

  • General Acute Care Hospital
  • Monroe, WI
  • NPI 1740291491
  Care Compare affiliation

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1083895312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR",
            "address_2": "SUITE 1008",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983331",
            "telephone_number": "920-206-6500",
            "fax_number": "920-261-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR",
            "address_2": "SUITE 1008",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983331",
            "telephone_number": "920-206-6500",
            "fax_number": "920-261-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "TERRY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WI",
            "license": "54555-021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083895312",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riverview Chiropractic, S.C.
• Rock River Community Clinic Inc
• Rock River Foot & Ankle Clinic, SC
• Rock River Foot and Ankle Clinic SC
• Cheryl Joy Roets, PHD
• Roundys Supermarkets Inc (Pick N Save Pharmacy)
• Herbert Scott Royce, PTA
• Sean H Ruch
• Hope Rohlen Ruedin, MSW, APSW
• Mary J Rupnow Charter, RN

• Sports Medicine (Orthopaedic Surgery) Physician in Watertown, WI
• Providers in Watertown, WI by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.