Individual provider Active NPI

Marek J. Rozek, PA-C

  • Physician Assistant
  • Waterloo, IA
National Provider Identifier
1386676971
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01652 Issued in IA
Practice address
2710 Saint Francis Dr
Suite 110
Waterloo, IA 50702-5619
Phone
(391) 272-5000
Fax
(319) 272-6775
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01652 IA Primary

Addresses

Primary practice location

2710 Saint Francis Dr
Suite 110
Waterloo, IA 50702-5619

Mailing address

2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051003000738 IA Practitioner - Physician Assistant 8628003241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
01652IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Emergency Physicians LLP Physician Assistant CurrentSince Dec 22, 2014 Accepting new patients

Locations

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1386676971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "address_2": "SUITE 110",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "391-272-5000",
            "fax_number": "319-272-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZEK",
        "first_name": "MAREK",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "01652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.