Individual provider Active NPI

Roman Magidenko, MD

  • Anesthesiology Physician
  • Royal Oak, MI
National Provider Identifier
1124090428
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301062612 Issued in MI
Practice address
3601 W 13 Mile Rd
Anesthesiology Dept
Royal Oak, MI 48073-6712
Phone
(248) 723-1635
Fax
(248) 723-1681
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301062612 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Anesthesiology Dept
Royal Oak, MI 48073-6712

Mailing address

3601 W 13 Mile Rd
Anesthesiology Dept
Royal Oak, MI 48073-6712
Phone (248) 723-1635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040226000058 MI Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 1052207032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Critical Care (Intensivists)
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (214) 687-0001

Hospital & facility affiliations

  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Jan 1, 2021 Accepting new patients
American Anesthesiology Associates of Michigan, PC Anesthesiology Past Accepting new patients
Bloomfield Anesthesia, PC Anesthesiology Past Accepting new patients

Locations

3601 W 13 Mile Rd
Royal Oak, MI 48073

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 3

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 1

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124090428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "ANESTHESIOLOGY DEPT",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-723-1635",
            "fax_number": "248-723-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "ANESTHESIOLOGY DEPT",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-723-1635",
            "fax_number": "248-723-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGIDENKO",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301062612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.