Jacob Royal, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60570569 Issued in WA

Practice address

5015 Lucena Dr
Pasco, WA 99301-8370

Phone

(509) 380-7378

NPI assigned

Sep 25, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Shepherd Health Care SystemGroup PAC ID 9133033764, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Shepherd Medical Center Hospital, Hermiston, OR, CCN 381325

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jroyal1523415@direct.lhs.org

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.

• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Medicare reassignment Care Compare group NPD
• Adams County Public Hospital District 3

  • Critical Access Hospital
  • Othello, WA
  • NPI 1811108822
  Medicare reassignment NPD
• Grant County Public Hospital District 3

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ephrata, WA
  • NPI 1134283930
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1205942257
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Medicare reassignment NPD
• Washington Emergency Physician Partners PLLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1346586351
  Medicare reassignment NPD
• Royal Wellness

  • Urgent Care Clinic/Center
  • Pasco, WA
  • NPI 1154001378
  NPD Authorized official
• Okanogan Douglas County Hospital Dist1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1578649794
  NPD
• Washington Emergency Physician Partners, PLLC

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1598162844
  NPD
• Grant County Public Hospital District No. 3

  • Critical Access Hospital
  • Ephrata, WA
  • NPI 1811979610
  NPD (past)
• Hughes Physical Therapy, P.S.

  • Physical Therapist
  • Kennewick, WA
  • NPI 1811151277
  NPD (past)
• Woundcaremax PLLC

  • Specialist
  • Richland, WA
  • NPI 1710313861
  NPD (past)

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

• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Care Compare affiliation

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1194127746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 LUCENA DR",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018370",
            "telephone_number": "509-380-7378",
            "fax_number": "509-222-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 LUCENA DR",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018370",
            "telephone_number": "509-380-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYAL",
        "first_name": "JACOB",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-25",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60570569",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R41002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AP60570569",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jroyal1108648@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4804 W Clearwater Ave",
            "city": "Kennewick",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993362119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marvin Flores Roman, M.D.
• Rooted Counseling and Wellness Wa PLLC
• Laurel A Rose, LMT
• Jennifer Leigh Rossmeisl, CDP
• Royal Wellness
• Sophia Rubalcava, RN
• Laura Ruge
• Adely Ruiz
• Isabel Antonia Ruiz
• Miranda Rumsey, BA

• Family Nurse Practitioner in Pasco, WA
• Providers in Pasco, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.