Individual provider Active NPI

Anamika Roy, MD

  • Anesthesiology Physician
  • Valley Stream, NY
National Provider Identifier
1063517969
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2173191 Issued in NY
Practice address
648 Michelle Place
Valley Stream, NY 11581
Phone
(516) 791-4060
Fax
(516) 791-4060
NPI assigned
Sep 14, 2006
Last updated
Mar 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2173191 NY Primary

Addresses

Primary practice location

648 Michelle Place
Valley Stream, NY 11581

Mailing address

648 Michelle Place
Valley Stream, NY 11581
Phone (516) 791-4060

Other identifiers 1

IdentifierTypeStateIssuer
02136116MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20111018000616 NY Practitioner - Anesthesiology 0648442574 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Shore Anesthesia PCGroup PAC ID 1355443698, 3 clinicians
Gastroenterology Consultants of Long Island PCGroup PAC ID 0840236774, 4 clinicians

Practice addresses (Care Compare)

1 Arrowood LN
Melville, NY 11747-1503
Phone (631) 546-5081

2001 Marcus Ave
Suite E240
New Hyde Park, NY 11042-1092
Phone (516) 673-4801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2173191NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadowbrook Medical Associates Anesthesiology CurrentSince Sep 5, 2011 Accepting new patients
Gastroenterology Consultants of Long Island, PC CurrentSince Nov 13, 2011 Accepting new patients
Boulevard Anesthesia Associates, PC Anesthesiology Past Accepting new patients

Locations

2001 Marcus Ave
Ste E240
New Hyde Park, NY 11042
Phone (516) 502-2308

865 Merrick Ave
Ste 150N
Westbury, NY 11590
Phone (516) 542-3636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3699/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1063517969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 MICHELLE PLACE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11581",
            "telephone_number": "516-791-4060",
            "fax_number": "516-791-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 MICHELLE PLACE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11581",
            "telephone_number": "516-791-4060",
            "fax_number": "516-791-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "ANAMIKA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "2173191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02136116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.