Individual provider Active NPI

Jacob Richard Romm, MD

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1396322491
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
W6766 Issued in TX
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1100
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X W6766 TX Primary

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1100

Other practice location 1

624 E Front Ave
Spokane, WA 99202-2139
Phone (509) 626-9900

Other practice location 2

2301 Erwin Road
Durham, NC 27710-2139
Phone (919) 684-7293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260611003791 TX Practitioner - Diagnostic Radiology 9830575968

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Washington School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3600 Minnesota Dr
Suite 800
Edina, MN 55435-3039

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Diagnostic Radiology Past Accepting new patients

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1396322491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 E Front Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992022139",
            "country_code": "US",
            "telephone_number": "509-626-9900",
            "fax_number": "509-626-9917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 Erwin Road",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277102139",
            "country_code": "US",
            "telephone_number": "919-684-7293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMM",
        "first_name": "JACOB",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "W6766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.