Individual provider Active NPI

Jonathan Conrad Romanyshyn, MD

  • Surgery Physician
  • Fresno, CA
National Provider Identifier
1942450069
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A120296 Issued in CA
Practice address
255 N Herwaldt Dr
Fresno, CA 93701-2186
Phone
(866) 342-6012
NPI assigned
Sep 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A120296 CA
Surgery Physician 208600000X A120296 CA Primary

Addresses

Primary practice location

255 N Herwaldt Dr
Fresno, CA 93701-2186

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Other practice location 1

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160720000083 CA Practitioner - General Surgery 1153614763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Yale University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue166
Removal of skin lesions27
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120296CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central California Faculty Medical Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Central California Faculty Medical Group, Inc. Family Medicine CurrentSince Dec 1, 2024 Accepting new patients

Locations

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

255 N Herwaldt Dr
Fresno, CA 93701
Phone (559) 459-7300

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

2625 E Divisadero St
Ste 216
Fresno, CA 93721

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

Organizations & group practices 3

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 3

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": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1942450069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N HERWALDT DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012186",
            "telephone_number": "866-342-6012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2823 Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211324",
            "country_code": "US",
            "telephone_number": "559-459-6000",
            "fax_number": "559-459-3571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMANYSHYN",
        "first_name": "JONATHAN",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A120296",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A120296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.