Individual provider Active NPI

Roman T Pyasta, MD

  • Internal Medicine Physician
  • Waukesha, WI
National Provider Identifier
1487607115
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42394 Issued in WI
Practice address
W231N1440 Corporate CT
Waukesha, WI 53186-1303
Phone
(262) 896-6000
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42394 WI Primary

Addresses

Primary practice location

W231N1440 Corporate CT
Waukesha, WI 53186-1303

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2801 W Kinnickinnic River Pkwy
#135
Milwaukee, WI 53215-3669
Phone (414) 385-8600

Other identifiers 1

IdentifierTypeStateIssuer
34821300MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rpyasta25371@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20060209000434 WI Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5890700033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2790 Elm Tree HL
Howard, WI 54313-3004
Phone (920) 569-0299

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42394WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Internal Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 30, 2009 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 30, 2009 Accepting new patients
Aurora Health Care Metro, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
#135
Milwaukee, WI 53215
Phone (414) 385-8600

2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215
Phone (414) 385-1277

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

2424 S 90th St
Ste 310
West Allis, WI 53227
Phone (414) 328-8700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1487607115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W231N1440 CORPORATE CT",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861303",
            "telephone_number": "262-896-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "#135",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153669",
            "country_code": "US",
            "telephone_number": "414-385-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PYASTA",
        "first_name": "ROMAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "42394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34821300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpyasta25371@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "#135",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "#135",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.