Individual provider Active NPI

Gregory Romaniuk

  • Family Medicine Physician
  • Nampa, ID
National Provider Identifier
1144246729
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-165550 Issued in ID
Practice address
9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone
(208) 205-7282
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TP818 KY
Family Medicine Physician 207Q00000X LL29132 SC
Family Medicine Physician 207Q00000X ME104586 FL
Family Medicine Physician 207Q00000X M-165550 ID Primary

Addresses

Primary practice location

9850 W St Lukes Dr
Nampa, ID 83687-7912

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

9911 Corkscrew Rd Ste 200
Estero, FL 33928-3323
Phone (239) 237-5500

Other practice location 2

13691 Metro Pkwy Ste 400
Fort Myers, FL 33912-4349
Phone (239) 440-6456

Other identifiers 1

IdentifierTypeStateIssuer
001196700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090812000338 FL Practitioner - Family Practice 9335293265 Reassigns benefits to 2 organizations
I20220526002762 ID Practitioner - Family Practice 9335293265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

520 S Eagle Rd
Meridian, ID 83642-6351

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711

9850 St Lukes Dr
Nampa, ID 83687-7912

9850 W St Luke'S Dr
Nampa, ID 83687-7912

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME104586FLMDFamily Medicine Physician
M-165550IDMDFamily Medicine Physician
LL29132SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince May 9, 2022 Accepting new patients
Cape Coral Hospitalists Inc CurrentSince May 1, 2011 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince May 9, 2022 Accepting new patients
Hni Medical Services of Florida, LLC Family Medicine CurrentSince Jan 1, 2019 Accepting new patients

Locations

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

13681 Doctors Way
Rm 18027
Fort Myers, FL 33912
Phone (239) 210-4247

13881 Eagle Ridge Dr
Fort Myers, FL 33912
Phone (239) 495-4000

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

Organizations & group practices 4

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 3

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1144246729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 W ST LUKES DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877912",
            "telephone_number": "208-205-7282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9911 Corkscrew Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "339283323",
            "country_code": "US",
            "telephone_number": "239-237-5500",
            "fax_number": "888-828-5797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13691 Metro Pkwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124349",
            "country_code": "US",
            "telephone_number": "239-440-6456",
            "fax_number": "239-236-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMANIUK",
        "first_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP818",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL29132",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME104586",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-165550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001196700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.