Individual provider Active NPI

Nisha Ann Roy

  • Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1063903201
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95008421 Issued in CA
Practice address
1923 Coffee Rd Ste 12
Modesto, CA 95355-2708
Phone
(209) 409-8454
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180928002177 CA Practitioner - Nurse Practitioner 4981955051 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95008421CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Sep 1, 2024 Accepting new patients
Cep America - California Current Accepting new patients
Cep America-California CurrentSince Sep 1, 2024 Accepting new patients
Altamont Emergency Physicians Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Baz Allergy, Asthma & Sinus Center, Inc. Allergy CurrentSince Jul 22, 2018 Accepting new patients
Baz Allergy, Asthma & Sinus Center Allergy CurrentSince Jul 22, 2018 Accepting new patients
Baz Allergy, Asthma & Sinus Center, Inc. Allergy Current Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

7471 N Fresno St
Fresno, CA 93720
Phone (559) 436-4500

1560 W Lacey Blvd
Ste 103
Hanford, CA 93230
Phone (559) 582-8500

1415 Badger Flat Rd
Ste A
Los Banos, CA 93635
Phone (209) 710-8684

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

450 Glass Ln
Ste C
Modesto, CA 95356

1923 Coffee Rd
Ste 12C
Modesto, CA 95355
Phone (209) 409-8454

1420 N Tracy Blvd
Tracy, CA 95376
Phone (209) 832-6018

Interoperability endpoints

  • Direct secure messaging: nroy590362@hisp.ehr.sutterhealth.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X NP95008421 CA
Nurse Practitioner 363L00000X NP95008421 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

1923 Coffee Rd Ste 12
Modesto, CA 95355-2708

Mailing address

1923 Coffee Rd Ste 12
Modesto, CA 95355-2708
Phone (209) 409-8454

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2024.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1063903201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 COFFEE RD STE 12",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552708",
            "telephone_number": "209-409-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 COFFEE RD STE 12",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552708",
            "telephone_number": "209-409-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "NISHA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "NP95008421",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95008421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.