DR. ROMAN DMITRIYEV DO
NPI 1467193185
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Q: What is Roman Dmitriyev's NPI number?

The NPI number for Roman Dmitriyev is 1467193185. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Q: What is Roman Dmitriyev's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Roman Dmitriyev was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 05, 2022PECOS Enrolled

1441 N 12TH ST FL 2, PHOENIX, AZ 85006(602) 521-5969(602) 521-5987 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Roman Dmitriyev Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROMAN DMITRIYEV DO (NPI 1467193185) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467193185

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. ROMAN DMITRIYEVCredential: DO

Location Address1441 N 12TH ST FL 2Phoenix, AZ 85006-2837

Mailing Address1441 N 12th St Fl 2Phoenix, AZ 85006-2837 · (602) 521-5969 · Fax (602) 521-5987

Phone(602) 521-5969

Fax(602) 521-5987

Sole ProprietorYes

Enumeration DateApril 5, 2022

NPPES CertifiedApril 5, 2022

✔ NPI 1467193185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1441 N 12TH ST FL 2, Phoenix, AZ 85006

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Roman Dmitriyev Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MACKINZIE A STANLEY MD

Student in an Organized Health Care Education/Training Program