Clay Matthew Romanek, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

13641 Issued in MN

Practice address

11855 Ulysses St NE Ste 120
Blaine, MN 55434-3948

Phone

(763) 581-2273

NPI assigned

Apr 21, 2020

Last updated

Mar 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MN

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group
• Ridgeview Medical Center

  dba Ridgeview Medical Center CRNAs

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429
  Medicare reassignment Care Compare group
• North Memorial Health Care

  dba North Memorial Health Specialty Clinic

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1871927715
  NPD
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1437779360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4181 108TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497439",
            "telephone_number": "763-581-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 ULYSSES ST NE STE 120",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343948",
            "telephone_number": "763-581-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANEK",
        "first_name": "CLAY",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "13641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Ritter
• Nermin Girgis Rizk, D.D.S.
• Estrelita Lee Rogers
• Cindy Lynn Rolland, LADC
• Cris Roman, LMFT
• Kendra Kay Romer, PHARMD
• Mitchell L Rosenbloom, CHW
• Mikayla Paige Roseth
• Stephanie Keeffe Rossing, L.M.F.T.
• Brad Rote

• Medical Physician Assistant in Blaine, MN
• Providers in Blaine, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.