Roman T Lewicky, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

8674 Issued in AZ

Practice address

1485 N Turquoise Dr
Suite 200
Flagstaff, AZ 86001-1398

Phone

(928) 774-7757

Fax

(928) 774-7767

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northern Arizona Orthopaedics, LTD.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1164495503
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1497727838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 N VESELKA RANCH RD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860019341",
            "telephone_number": "928-774-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 N TURQUOISE DR",
            "address_2": "SUITE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011398",
            "telephone_number": "928-774-7757",
            "fax_number": "928-774-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWICKY",
        "first_name": "ROMAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "8674",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "8674",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "8674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard a Wood
• Alexander Gregory Leonard
• Bradley Lerud, DDS
• Sheldon I Levin, M.D.
• Alexander James Lew, DMD
• Yuri Lewicky, M.D.
• Theodore H Lewis Jr., MD
• Stephen F Lex, MD
• LHCG Lxxvii, LLC (Northern Arizona Home Health)
• Michael Tanner Libsack, DO

• Sports Medicine (Orthopaedic Surgery) Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.