Roman Dykyj Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD027187E Issued in PA

Practice address

8151 Revere St
Philadelphia, PA 19152-3002

Phone

(215) 624-3000

Fax

(215) 624-6855

NPI assigned

Oct 9, 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

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nazareth Hospital Hospital, Philadelphia, PA, CCN 390204

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Northeast Primary Care, PC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1760714208
  Medicare reassignment

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1891882973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8151 REVERE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523002",
            "telephone_number": "215-624-3000",
            "fax_number": "215-624-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8151 REVERE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523002",
            "telephone_number": "215-624-3000",
            "fax_number": "215-624-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKYJ",
        "first_name": "ROMAN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD027187E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT BLUE CROSS",
            "identifier": "0054192000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMINISTRATOR",
            "identifier": "A00995",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2061288",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HPE",
            "identifier": "0054192001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Normonique A Dyer, DO
• Renee S Dyer, DO
• Richard Dyer
• Taylor Simone Dyer
• Jennifer Dyke, RDH, PHDHP
• Stephanie Dykyj, M.ED.
• Ilene M Dyller, PH.D.
• Anna Dymarsky, D.O.
• Therese Marie Dymek, CRNP
• Daniel James Dymond, PA-C

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.