Roman Y Takasaki, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

182230-1205 Issued in UT

Practice address

336 W 100 S
Spanish Fork, UT 84660-5881

Phone

(801) 798-7301

Fax

(801) 798-8513

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Family Practice

Education

University of Utah School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canyon View Medical Group LLCGroup PAC ID 9739084351, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062
• Mountain View Hospital Hospital, Payson, UT, CCN 460013
• Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roman.takasaki.p1@direct.canyonviewmed.nextgenshare.com

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.

• Canyon View Medical Group LLC

  • Obstetrics & Gynecology Physician
  • Payson, UT
  • NPI 1477709772
  Medicare reassignment Care Compare group NPD
• Canyon View Medical Group LLC

  • Family Medicine Physician
  • Salem, UT
  • NPI 1225739857
  NPD
• Canyon View Medical Group LLC

  • Pediatrics Physician
  • Spanish Fork, UT
  • NPI 1457638223
  NPD
• Canyon View Medical Group LLC

  • Family Medicine Physician
  • Spanish Fork, UT
  • NPI 1538194477
  NPD (past)

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Spanish Fork, UT
  • NPI 1124661384
  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1679426944

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • American Fork, UT
  • NPI 1982557252

  Hospital

  Care Compare affiliation
• Mountain View Hospital, Inc.

  • General Acute Care Hospital
  • Payson, UT
  • NPI 1487607669
  Care Compare affiliation

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1669428611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W CENTER ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602060",
            "telephone_number": "801-798-7301",
            "fax_number": "801-798-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W 100 S",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846605881",
            "telephone_number": "801-798-7301",
            "fax_number": "801-798-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKASAKI",
        "first_name": "ROMAN",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "182230-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summit Spa & Float - Spanish Fork LLC
• Summit Spa & Float Inc.
• Sunset Living LLC
• Superior Healthcare of Spanish Fork
• Amy Michelle Sygnatowicz
• Kelsie Taney, RN
• Sarah Ngocvi Tang, MD
• Laurie Mae Tashman, REGISTERED NURSE
• Brinindune Taylor, DPT
• Courtney Sue Taylor, DNP, APRN, FNP-C

• Family Medicine Physician in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.