NPIMap

Individual provider Active NPI

Roman Berezovski, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Milwaukee, WI
National Provider Identifier
1871569830
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
48739-20 Issued in WI
Practice address
8901 N 76TH St
Milwaukee, WI 53223-1901
Phone
(414) 354-0772
Fax
(414) 365-0773
NPI assigned
Feb 28, 2006
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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 48739-20 WI Primary

Addresses

Primary practice location

8901 N 76TH St
Milwaukee, WI 53223-1901

Mailing address

7217 W Lafayette PL
Mequon, WI 53092-1572
Phone (414) 248-8933

Other identifiers 1

IdentifierTypeStateIssuer
34811900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000814 WI Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain ManagementPractitioner - Pain Management 7618993361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48739-20WIMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Dec 22, 2022 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 22, 2022 Accepting new patients
Pain Management & Treatment Center, S.C. CurrentSince Jun 1, 2012 Accepting new patients
Mercy Health System Corporation Past Accepting new patients
Advanced Pain Management SC Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

8901 N 76th St
Milwaukee, WI 53223
Phone (414) 354-0772

Interoperability endpoints

  • Direct secure messaging: rberezovski99204@direct.mhemail.org

Organizations & group practices 6

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.

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1871569830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7217 W LAFAYETTE PL",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530921572",
            "telephone_number": "414-248-8933",
            "fax_number": "414-365-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231901",
            "telephone_number": "414-354-0772",
            "fax_number": "414-365-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREZOVSKI",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WI",
            "license": "48739-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34811900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.