Individual provider Active NPI

Bruce J Romanczuk, MD

  • Otolaryngology Physician
  • Manahawkin, NJ
National Provider Identifier
1427136993
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
25MA03704500 Issued in NJ
Practice address
1145 Beacon Avenue
Manahawkin, NJ 08050-2626
Phone
(609) 597-7110
Fax
(609) 597-7113
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA03704500 NJ Primary
Otolaryngology Physician 207Y00000X MD017065E PA

Addresses

Primary practice location

1145 Beacon Avenue
Manahawkin, NJ 08050-2626

Mailing address

1145 Beacon Avenue
Manahawkin, NJ 08050-2626
Phone (609) 597-7110

Other identifiers 4

IdentifierTypeStateIssuer
0185580000OtherNJAMERIHEALTH
0600528OtherGHI
4100689OtherAETNA
82567570OtherLOCAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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
I20091208000023 NJ Practitioner - Otolaryngology 5294874012 Reassigns benefits to 3 organizations
I20111108000417 PA Practitioner - Otolaryngology 5294874012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Pittsburgh School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

132 Grove St
Suite a
Haddonfield, NJ 08033-1224
Phone (856) 354-2211

15200 Bustleton Ave
Philadelphia, PA 19116-1196
Phone (215) 464-6383

175 Cross Keys Rd
Suite 300a
Berlin, NJ 08009-9263
Phone (856) 872-7055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03704500NJMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA CurrentSince Mar 28, 2012 Accepting new patients
Berlin Medical Associates, P.a. CurrentSince Feb 1, 2010 Accepting new patients
Advocare, LLC Past Accepting new patients
Community Neurology Associates PC Past Accepting new patients

Locations

160 S White Horse Pike
Berlin, NJ 08009
Phone (609) 767-0077

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

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

Interoperability endpoints

  • Direct secure messaging: bruce.romanczuk@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427136993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BEACON AVENUE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502626",
            "telephone_number": "609-597-7110",
            "fax_number": "609-597-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 BEACON AVENUE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502626",
            "telephone_number": "609-597-7110",
            "fax_number": "609-597-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANCZUK",
        "first_name": "BRUCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA03704500",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD017065E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0185580000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0600528",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4100689",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL",
            "identifier": "82567570",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.