Individual provider Active NPI

Roman Povolotskiy, MD

  • Otolaryngology Physician
  • Newark, NJ
National Provider Identifier
1225667355
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
25MA12473000 Issued in NJ
Practice address
90 Bergen St Ste 8100
Newark, NJ 07103-2425
Phone
(973) 972-2548
NPI assigned
Apr 1, 2020
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA12473000 NJ Primary

Addresses

Primary practice location

90 Bergen St Ste 8100
Newark, NJ 07103-2425

Mailing address

400 Valley Rd Ste 105
Mt Arlington, NJ 07856-2316
Phone (973) 770-7101

Other practice location 1

400 Valley Rd Ste 105
Mount Arlington, NJ 07856-2316
Phone (973) 770-7101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250711000805 NJ Practitioner - Otolaryngology 2567977416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

400 Valley Rd
Suite 105
Mount Arlington, NJ 07856-2316
Phone (973) 770-7101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12473000NJMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Aug 1, 2025 Accepting new patients
Advocare , LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

400 Valley Rd
Ste 105
Mt Arlington, NJ 07856
Phone (973) 770-0472

Interoperability endpoints

  • Direct secure messaging: roman.povolotskiy@advocaredoctors.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1225667355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VALLEY RD STE 105",
            "city": "MT ARLINGTON",
            "state": "NJ",
            "postal_code": "078562316",
            "telephone_number": "973-770-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Valley Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Mount Arlington",
            "state": "NJ",
            "postal_code": "078562316",
            "country_code": "US",
            "telephone_number": "973-770-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POVOLOTSKIY",
        "first_name": "ROMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA12473000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.