Individual provider Active NPI

Roman Peter Urbanczyk, M.D.

  • Internal Medicine Physician
  • Valley Stream, NY
National Provider Identifier
1114933918
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
182869 Issued in NY
Practice address
15 Fletcher Ave
Valley Stream, NY 11580-4000
Phone
(516) 825-3666
Fax
(516) 872-5133
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 182869 NY Primary

Addresses

Primary practice location

15 Fletcher Ave
Valley Stream, NY 11580-4000

Mailing address

15 Fletcher Ave
Valley Stream, NY 11580
Phone (516) 825-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040505001315 NY Practitioner - Internal Medicine 7315935442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15 Fletcher Ave
Valley Stream, NY 11580-4000

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Mt. Sinai at Home Home health agency, Westbury, NY, CCN 337246
  • Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259
  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as individual
Quality
68.68
Improvement activities
40
Cost
81.33

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHCDBD/Endpoint/DHCDBD

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1114933918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FLETCHER AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-825-3666",
            "fax_number": "516-872-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FLETCHER AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804000",
            "telephone_number": "516-825-3666",
            "fax_number": "516-872-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANCZYK",
        "first_name": "ROMAN",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "182869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.