Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Roman Ivankiv

Individual provider Foot Surgery Podiatrist · NPI 1528517331

Roman Ivankiv is a Podiatry in St Augustine, Florida. Graduated from Barry University School of Podiatric Medicine in 2015, 11 years ago. Practices with Coastal Foot and Ankle Wellness Center LLC, a 3-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Alabama and Florida.

Years since qualifying
11
Trained at
Barry University School of Podiatric Medicine
Licensed in
AL, FL
In the registry since
2016
Specialties on file
2

Practice location Address checks out

1740 Tree Blvd Ste 112
St Augustine, FL 32084-5720
Phone: (904) 826-1900
Fax: (904) 826-1920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 204 Luds Way, Dothan, AL 36303-6350 — (334) 678-7036

Specialties & licences

Foot Surgery Podiatrist (primary) Taxonomy 213ES0131X · Licence PO4215 (FL)
Foot Surgery Podiatrist Taxonomy 213ES0131X · Licence 338 (AL)

Record details

NPI number1528517331
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 22, 2016
Last updated in NPPESMarch 28, 2021
Certification dateMarch 28, 2021
Mailing address1740 Tree Blvd Ste 112, St Augustine, FL 32084-5720

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolBARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduated 2015 (11 years in practice)
Group practice Coastal Foot And Ankle Wellness Center Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in St Augustine