Roman Krutikov, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

100 Eagleville Rd
Eagleville, PA 19403-1829

Phone

(267) 255-3752

NPI assigned

Sep 29, 2020

Last updated

Sep 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Temple University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Aria Health Physician Services

  dba Richboro Medical

  • Family Medicine Physician
  • Richboro, PA
  • NPI 1750949806
  Medicare reassignment Care Compare group
• Aria Health Physician Services

  dba Geoffrey W. Temple Family Medical Associates

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD
• Aria Health Physician Services

  dba Ahps Mayfair Professionals

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1992458848
  NPD

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1760099105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEIGHTS LN APT 8F",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190537618",
            "telephone_number": "267-255-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAGLEVILLE RD",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031829",
            "telephone_number": "267-255-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUTIKOV",
        "first_name": "ROMAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Kane, PH.D., CCC-SLP
• Maryann Kelly, PT
• Marisa Kling
• Frances Krouse, MSPT
• Christopher Krug, PA
• Kairavi Kedar Kulkarni, MS, RD, LDN
• Mary Ann Leary, DO
• Stephanie Lee, M.A. CCC-SLP
• Richard Kenneth Lescavage
• Cynthia Lichtstein, OTR/L

• Physician Assistant in Eagleville, PA
• Providers in Eagleville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.