Individual provider Active NPI

Roman Gimpelevich, M.D.

  • Pulmonary Disease Physician
  • Lakeland, FL
National Provider Identifier
1720284102
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME101100 Issued in FL
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME101100 FL Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019

Mailing address

PO Box 95004
Lakeland, FL 33804-5004
Phone (863) 680-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1720284102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95004",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338045004",
            "telephone_number": "863-680-7000",
            "fax_number": "863-680-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIMPELEVICH",
        "first_name": "ROMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME101100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.