Roman W Mandzij, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-096445 Issued in IL

Practice address

525 Winnetka Ave
Winnetka, IL 60093-4050

Phone

(847) 501-4060

Fax

(847) 501-4063

NPI assigned

Jun 5, 2006

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 IL

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

Internal Medicine

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Winnetka Avenue Physicians SCGroup PAC ID 1557672334, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caress Home Health Care Inc Home health agency, Skokie, IL, CCN 147747
• Residential Home Health Home health agency, Northbrook, IL, CCN 147001
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Swedish Hospital Hospital, Chicago, IL, CCN 140114

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Winnetka Avenue Physicians, SC

  • Internal Medicine Physician
  • Winnetka, IL
  • NPI 1346633971
  Medicare reassignment Care Compare group NPD
• North Shore Physicians Group, LLC

  • Internal Medicine Physician
  • Winnetka, IL
  • NPI 1093768228
  NPD (past)
• Presence Healthcare Services

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1093780181
  NPD (past)

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

• Caress Home Health Care Inc

  • Home Health Agency
  • Skokie, IL
  • NPI 1508856758
  Care Compare affiliation
• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Residential Home Health Illinois, LLC

  • Home Health Agency
  • Northbrook, IL
  • NPI 1114673787
  Care Compare affiliation
• Swedish Covenant Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1841239902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WINNETKA AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934050",
            "telephone_number": "847-501-4060",
            "fax_number": "847-501-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WINNETKA AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934050",
            "telephone_number": "847-501-4060",
            "fax_number": "847-501-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDZIJ",
        "first_name": "ROMAN",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-096445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Winnetka, IL
• Providers in Winnetka, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.