Individual provider Active NPI

Pradeep Kumar Roy, M.D.

  • Psychiatry Physician
  • Kingwood, TX
National Provider Identifier
1033226352
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
H3160 Issued in TX
Practice address
2527 Chestnut Ridge Dr
Kingwood, TX 77339-3031
Phone
(281) 358-4747
Fax
(281) 358-2213
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X H3160 TX Primary

Addresses

Primary practice location

2527 Chestnut Ridge Dr
Kingwood, TX 77339-3031

Mailing address

2527 Chestnut Ridge Dr
Kingwood, TX 77339-3031
Phone (832) 269-8440

Other practice location 1

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 970-7000

Other identifiers 1

IdentifierTypeStateIssuer
133716403MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100827000907 TX Practitioner - NeuropsychiatryPractitioner - Psychiatry 3072637016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeuropsychiatryAlso: Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Physician NetworkGroup PAC ID 0547333890, 121 clinicians

Practice addresses (Care Compare)

3250 Fannin St
Beaumont, TX 77701-3903
Phone (409) 212-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Feb 1, 2023 Accepting new patients
Lakeland Health Services, LLC Past Accepting new patients
Courtesy Healthcare Services, LLC. Past Accepting new patients
Jamison Professional Counseling Center Inc Past Accepting new patients
Baptist Hospitals of Southeast Texas Past Accepting new patients

Locations

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

3070 College St
Ste 120
Beaumont, TX 77701
Phone (409) 835-2300

3250 Fannin St
Beaumont, TX 77701
Phone (409) 212-7000

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1033226352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 CHESTNUT RIDGE DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393031",
            "telephone_number": "832-269-8440",
            "fax_number": "281-358-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 CHESTNUT RIDGE DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393031",
            "telephone_number": "281-358-4747",
            "fax_number": "281-358-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 Taub Loop",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301608",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "PRADEEP",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H3160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133716403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.