Individual provider Active NPI

Roman Lawrin, PA-C

  • Surgical Physician Assistant
  • Traverse City, MI
National Provider Identifier
1871874552
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601006111 Issued in MI
Practice address
1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone
(231) 935-5880
NPI assigned
Sep 7, 2011
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601006111 MI Primary
Surgical Physician Assistant 363AS0400X 0010-05643 NC

Addresses

Primary practice location

1221 Sixth St Ste 300
Traverse City, MI 49684-2360

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345

Other practice location 1

1105 Sixth St
Traverse City, MI 49684
Phone (231) 935-7514

Other practice location 2

1221 Sixth St Ste 100
Traverse City, MI 49684-2359
Phone (231) 935-0322

Other practice location 3

1221 Sixth St Ste 100
Traverse City, MI 49684-2359
Phone (231) 935-0322

Other practice location 4

3537 W Front St Ste E
Traverse City, MI 49684-7943
Phone (231) 935-5880

Other practice location 5

217 S Madison St
Traverse City, MI 49684-2321
Phone (231) 392-8400

Other practice location 6

1221 Sixth St Ste 100
Traverse City, MI 49684-2359
Phone (231) 935-0322

Other practice location 7

430 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2304

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000412 MI Practitioner - Physician Assistant 1658542519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

1121 6TH St
Suite 316
Traverse City, MI 49684-2345
Phone (231) 392-8280

1221 6TH St
Traverse City, MI 49684-2360

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Jun 27, 2022 Accepting new patients
Munson Medical Center PastSince Mar 30, 2025 Accepting new patients
DBMJ Rehabilitation Services PLLC PastSince Mar 30, 2025 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

Organizations & group practices 5

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 1

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": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1871874552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842360",
            "telephone_number": "231-935-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "49684",
            "country_code": "US",
            "telephone_number": "231-935-7514",
            "fax_number": "231-392-0039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842359",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842359",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3537 W Front St Ste E",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847943",
            "country_code": "US",
            "telephone_number": "231-935-5880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842321",
            "country_code": "US",
            "telephone_number": "231-392-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842359",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "430 Waterstone Dr",
            "address_purpose": "LOCATION",
            "city": "Hillsborough",
            "state": "NC",
            "postal_code": "272789078",
            "country_code": "US",
            "telephone_number": "984-215-2304",
            "fax_number": "984-215-2005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRIN",
        "first_name": "ROMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601006111",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-05643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.