Roman Davidenko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-121391 Issued in OH

Practice address

1440 S Canfield Niles Rd Ste B
Austintown, OH 44515-4087

Phone

(234) 264-8080

Fax

(234) 264-8066

NPI assigned

Jul 1, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Family Practice

Education

Northeastern Ohio University College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

River Valley Physicians LLCGroup PAC ID 3971506932, 56 clinicians

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• River Valley Physicians, LLC

  • Multi-Specialty Clinic/Center
  • East Liverpool, OH
  • NPI 1891756870
  Medicare reassignment Care Compare group NPD
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Insight Foundation of Trumbull

  • Internal Medicine Physician
  • Warren, OH
  • NPI 1265268957

  Family Medicine

  Medicare reassignment NPD
• SHC Youngstown Ohio Outpatient Services LLC

  • Urgent Care Clinic/Center
  • Austintown, OH
  • NPI 1114450764
  Medicare reassignment
• Steward Medical Group Inc.

  • Internal Medicine Physician
  • Brookfield, OH
  • NPI 1902347438
  Medicare reassignment
• Insight Foundation of Trumbull

  • Psychiatric Hospital Unit
  • Warren, OH
  • NPI 1770319451
  NPD
• Steward Trumbull Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Warren, OH
  • NPI 1053844761
  NPD (past)
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661
  NPD (past)

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

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1366739039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 OAK KNOLL DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445121013",
            "telephone_number": "330-328-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 S CANFIELD NILES RD STE B",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445154087",
            "telephone_number": "234-264-8080",
            "fax_number": "234-264-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDENKO",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-121391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Lynn Curran
• Shelby Nicole Dailey
• Mitchell Dalvin, D.P.M.
• Angelina Jade Daniels
• Jamie Dattilio, CDCA
• Kerry Davies
• Anissa Marie Davis
• Janet Lynn Davis
• Rebecca Davis
• Anthony B Dawson

• Family Medicine Physician in Austintown, OH
• Providers in Austintown, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.