1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Surgery
  6. NPI Profile

DR. ROMAN M SYDORAK M.D.
NPI 1467560045
Surgery - Pediatric Surgery in Los Angeles, CA

Active since August 25, 2006PECOS Enrolled
4760 W SUNSET BLVD, 3RD FLOOR, LOS ANGELES, CA 90027(323) 783-7507(323) 783-8747 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Roman M Sydorak M.d. NPPES

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

DR. ROMAN M SYDORAK M.D. (NPI 1467560045) is an individual pediatric surgery provider in Los Angeles, California, licensed in California (A67995) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467560045
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameDR. ROMAN M SYDORAKCredential: M.D.
Location Address4760 W SUNSET BLVD, 3RD FLOORLos Angeles, CA 90027-6063
Mailing Address4760 W Sunset Blvd, 3rd FloorLos Angeles, CA 90027-6063 · (323) 783-7507 · Fax (323) 783-8747
Phone(323) 783-7507
Fax(323) 783-8747
Sole ProprietorYes
Enumeration DateAugust 25, 2006
Last NPPES UpdateDecember 1, 2021
NPPES CertifiedDecember 1, 2021
✔ NPI 1467560045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in CA · A67995
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
4760 W SUNSET BLVD, Los Angeles, CA 90027
Open in Google Maps ↗

Other Identifiers 1

Medicaid00A679950CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Roman M Sydorak M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Roman Sydorak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
Same address
Health Maintenance Organization
4760 W SUNSET BLVD
Los Angeles, CA 90027
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1396287082 (California)
  • 13,921 clinicians in this Medicare group
NPI 1134151657 (323) 783-4011

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

SOMJOT S. BRAR MD
Internal Medicine (Cardiovascular Disease)
4760 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 783-4011
DR. BROOKE VUONG M.D.
Student in an Organized Health Care Education/Training Program
4760 W SUNSET BLVD, 3RD FLOOR
LOS ANGELES, CA 90027
Los Angeles County (323) 783-1737
KARIN W HOLMES PSW
Social Worker (Clinical)
4760 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 783-4011
DR. SHANT SHEKHERDIMIAN MD
Surgery
4760 W SUNSET BLVD, 3RD FLOOR
LOS ANGELES, CA 90027
Los Angeles County (323) 783-1737
SHIRIN KAZEMI
Physician Assistant (Surgical)
4760 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (800) 954-8000
DR. DAMIEN CRAIG RODGER MD, PHD
Ophthalmology
4760 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 783-4011
CAROL JACKSON CRNA
Nurse Anesthetist, Certified Registered
4760 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 783-4011
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Health Maintenance Organization
4760 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 783-4011

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roman Sydorak's NPI number?

The NPI number for Roman Sydorak is 1467560045. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Roman Sydorak located?

Roman Sydorak practices at 4760 W Sunset Blvd 3rd Floor, Los Angeles, CA 90027. The listed phone number is (323) 783-7507.

What is Roman Sydorak's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Roman Sydorak enrolled in Medicare?

Yes. Roman Sydorak is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Roman Sydorak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roman Sydorak reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roman Sydorak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Roman Sydorak was last updated on December 1, 2021. 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.