Individual provider Active NPI

Roman Zolotoy

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Big Rapids, MI
National Provider Identifier
1831486950
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
5101019527 Issued in MI
Practice address
20095 Gilbert Rd Ste B
Big Rapids, MI 49307-2366
Phone
(231) 592-1360
Fax
(231) 592-1361
NPI assigned
Jul 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 5101019527 MI Primary

Addresses

Primary practice location

20095 Gilbert Rd Ste B
Big Rapids, MI 49307-2366

Mailing address

7 Seaport Dr
Quincy, MA 02171-1576
Phone (248) 390-3288

Other identifiers 1

IdentifierTypeStateIssuer
110119479AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20180924002882 MI Practitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 3173802824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Primary Care Partners P CGroup PAC ID 8527044551, 21 clinicians

Practice addresses (Care Compare)

20095 Gilbert Rd
Suite B
Big Rapids, MI 49307-2366
Phone (231) 592-1360

Hospital & facility affiliations

  • Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093
  • Corewell Health Reed City Hospital Hospital, Reed City, MI, CCN 231323

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Pain Center PC Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Michigan Primary Care Partners P C Internal Medicine CurrentSince Sep 17, 2018 Accepting new patients

Locations

20095 Gilbert Rd
Big Rapids, MI 49307
Phone (231) 305-4095

20095 Gilbert Rd
Ste B
Big Rapids, MI 49307
Phone (231) 408-3208

20095 Gilbert Rd
Ste A
Big Rapids, MI 49307
Phone (231) 592-3102

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17442/brand/2/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1831486950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SEAPORT DR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021711576",
            "telephone_number": "248-390-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20095 GILBERT RD STE B",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072366",
            "telephone_number": "231-592-1360",
            "fax_number": "231-592-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLOTOY",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-10",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "5101019527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110119479A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.