Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162), for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1336553874
Roman Igorevich KrivochenitserM.D.
Active
NPI Number1336553874
NPI TypeNPI-1 Individual
SpecialtyOphthalmology, Glaucoma Specialist
Provider Details
NPI1336553874
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2014-06-12
Last Updated2024-12-11
Mailing Address5504 Tequesta Dr
West Bloomfield, MI 48323-2356
United States
Phone: (248) 895-9719
📍 View Map
Primary Practice Address1000 E Paris Avenue Se, Ste 130
Grand Rapids, MI 49546-3680
United States
Phone: (616) 949-2001 | Fax: (616) 949-8620
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207W00000X – OphthalmologyCODR0061743
No207W00000X – OphthalmologyWI5859-851
No207W00000X – OphthalmologyMI4301105291
No207WX0009X – Ophthalmology, Glaucoma SpecialistCODR0061743
Yes207WX0009X – Ophthalmology, Glaucoma SpecialistMI4301105291
Export Provider Record NPI 1336553874
Search for More Providers
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →

About NPI 1336553874

Roman Igorevich Krivochenitser M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1336553874. The primary specialty listed is Ophthalmology, Glaucoma Specialist. The provider is located in Grand Rapids, MI. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2014-06-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1336553874?

NPI 1336553874 belongs to Roman Igorevich Krivochenitser M.D., a Ophthalmology, Glaucoma Specialist in Grand Rapids, MI. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1336553874 active?

The current status of NPI 1336553874 in the NPPES registry is Active. The record was last updated on 2024-12-11.

What specialty is NPI 1336553874?

NPI 1336553874 is classified under the taxonomy Ophthalmology, Glaucoma Specialist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1336553874?

You can verify NPI 1336553874 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1336553874?

The primary practice address on file for NPI 1336553874 is 1000 E Paris Avenue Se, Grand Rapids, MI 49546-3680. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1336553874 issued?

NPI 1336553874 was first issued (enumerated) on 2014-06-12. The NPPES record was last updated on 2024-12-11.

Practice Location Map

Roman Igorevich Krivochenitser is located at 1000 E Paris Avenue Se, Grand Rapids, MI. Use the map below to find directions or verify the practice location.

📍 1000 E Paris Avenue Se, Grand Rapids, MI 49546-3680  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Roman Igorevich Krivochenitser. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1336553874. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
OphthalmologyDR0061743CO
Ophthalmology5859-851WI
Ophthalmology4301105291MI
Ophthalmology, Glaucoma SpecialistDR0061743CO
Ophthalmology, Glaucoma Specialist4301105291MI
Data Verified from CMS NPPES Last synced: 2026-08-13 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162