NPIMap

Individual provider Active NPI

Romeo Anton Pavlic, MD

  • Cardiovascular Disease Physician
  • Spokane, WA
National Provider Identifier
1508815036
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
00018454 Issued in WA
Practice address
140 S Arthur St Ste 408
Spokane, WA 99202-2220
Phone
(509) 557-7776
Fax
(509) 838-9683
NPI assigned
May 10, 2006
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X M4759 ID
Cardiovascular Disease Physician 207RC0000X 00018454 WA Primary

Addresses

Primary practice location

140 S Arthur St Ste 408
Spokane, WA 99202-2220

Mailing address

PO Box 637
Spokane, WA 99210-0637
Phone (509) 557-7776

Other practice location 1

303 E King Ave
Chewelah, WA 99109-8998
Phone (509) 557-7776

Other identifiers 2

IdentifierTypeStateIssuer
003876300MedicaidID
1788009MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 637
Spokane, WA 99210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as individual
Quality
93.33
Improvement activities
40
Cost
58.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4759IDMDCounselor
M4759IDMDCardiovascular Disease Physician
00018454WAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Wa Past Accepting new patients
Inland Cardiology Associates, P.S. Cardiovascular Disease PastSince Jan 1, 1999 Accepting new patients
Insight Diagnostic Imaging PA Cardiovascular Disease Past Accepting new patients

Organizations & group practices 4

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 4

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1508815036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992100637",
            "telephone_number": "509-557-7776",
            "fax_number": "509-838-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S ARTHUR ST STE 408",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022220",
            "telephone_number": "509-557-7776",
            "fax_number": "509-838-9683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E King Ave",
            "address_purpose": "LOCATION",
            "city": "Chewelah",
            "state": "WA",
            "postal_code": "991098998",
            "country_code": "US",
            "telephone_number": "509-557-7776",
            "fax_number": "509-838-9683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLIC",
        "first_name": "ROMEO",
        "middle_name": "ANTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M4759",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "00018454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003876300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1788009",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.