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Petr Roytman

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

Based on the most recent information from CMS, provider Petr Roytman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1346562634
Provider Type
Individual
Full Name
Roytman, Petr
Title
Mr.
Credential
RPA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
2/27/2010
Last Updated
11/8/2012

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

(718) 226-6964

Mailing Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

(718) 226-6964

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 013683 New York

Provider Identifiers

ID	Description	Issuer
ID 03497601	Description Medicaid	Issuer Unlisted New York

Petr Roytman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Rasile, Jacqueline Marie

Frasca, Francesca Marie

Paul, Lisa

Scribani, Stephanie Nicole

Serino, Jessica

Gucciardi, Lauren M

Feyijinmi, Olusegun I

Cepeda, Roger Alejandro

Marchese, Robert Vito

Crispi, Victoria