Jacques A Roy, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

G6995 Issued in TX

Practice address

2617 Bolton Boone Dr
Suite B
Desoto, TX 75115-2074

Phone

(972) 709-1781

Fax

(972) 709-1782

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medistat Group Associates, Inc.

  • Adult Medicine Physician
  • Desoto, TX
  • NPI 1376565341
  NPD (past)
• Central Seniors Inc

  • Preferred Provider Organization
  • Indianapolis, IN
  • NPI 1013029321
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1154434439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 BOLTON BOONE DR",
            "address_2": "SUITE B",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152074",
            "telephone_number": "972-709-1781",
            "fax_number": "972-709-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 BOLTON BOONE DR",
            "address_2": "SUITE B",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152074",
            "telephone_number": "972-709-1781",
            "fax_number": "972-709-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "JACQUES",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G6995",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "G6995",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "G6995",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140352946",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosebud Senior Services LLC
• Lanetta Dorose Ross, LPC/LCDC
• Rachel Ross
• Joette Rouse
• Nashay Alexandra Rowe
• Royalty Health Services
• Jocelyn Ruiz
• Tamika D Russell, LPC
• S.a.N.D. X3 LLC
• Sachin Harishchandrabhan Sachdev, MD

• Adult Medicine Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Adult Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.