NPIMap

Individual provider Active NPI

Roy William Harris, D.O.

  • Internal Medicine Physician
  • Bucyrus, OH
National Provider Identifier
1043218902
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34-005746 Issued in OH
Practice address
510 Hill St
Bucyrus, OH 44820-1554
Phone
(419) 562-9834
Fax
(419) 562-9977
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34-005746 OH Primary
Internal Medicine Physician 207R00000X DO-469 AL

Addresses

Primary practice location

510 Hill St
Bucyrus, OH 44820-1554

Mailing address

510 Hill St
Bucyrus, OH 44820-1554
Phone (419) 562-9834

Other identifiers 1

IdentifierTypeStateIssuer
0931906MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000392 OH Practitioner - Internal MedicinePractitioner - Family Practice 1557256989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

510 Hill St
Bucyrus, OH 44820-1554
Phone (419) 562-9834

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-469ALMDInternal Medicine Physician
34-005746OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bucyrus Internal Medicine, Inc. CurrentSince Jul 1, 1999 Accepting new patients
Bucyrus SNF Healthcare LLC Past Accepting new patients
Legacy Bucyrus Operating Company, LLC Past Accepting new patients

Locations

510 Hill St
Bucyrus, OH 44820
Phone (419) 562-9834

139 Gaius St
Bucyrus, OH 44820
Phone (419) 562-4677

Interoperability endpoints

  • Direct secure messaging: royharris@bucyrusim.direct.emds.com

Organizations & group practices 3

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 4

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1043218902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HILL ST",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448201554",
            "telephone_number": "419-562-9834",
            "fax_number": "419-562-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HILL ST",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448201554",
            "telephone_number": "419-562-9834",
            "fax_number": "419-562-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-005746",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO-469",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0931906",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucyrus, OH

Sources for this page

Verify at the official NPI Registry.