Individual provider Active NPI

Kaushik Roy, M.D.

  • Psychiatry Physician
  • Hartford, CT
National Provider Identifier
1205234754
Registry record updated Feb 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
056652 Issued in CT
Practice address
200 Retreat Ave
Hartford, CT 06106-3309
Phone
(860) 545-7200
NPI assigned
Dec 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 056652 CT Primary
Child & Adolescent Psychiatry Physician 2084P0804X 056652 CT
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

200 Retreat Ave
Hartford, CT 06106-3309

Mailing address

200 Retreat Ave
Hartford, CT 06106-3309
Phone (860) 545-7200

Other practice location 1

8900 Van Wyck Expressway
Jamaica Hospital Medical Center
Jamaica, NY 11418
Phone (718) 206-6000 ext. 7708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
056652CTMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St. Luke's Physician Group, Inc. Psychiatry CurrentSince Aug 25, 2019 Accepting new patients
Eastern Pennsylvania Physician Alliance LLC Child & Adolescent Psychiatry CurrentSince Jun 1, 2023 Accepting new patients
Penn Foundation Inc CurrentSince Jul 1, 2022 Accepting new patients
St Luke's Physician Group Inc CurrentSince Aug 25, 2019 Accepting new patients

Locations

1107 Eaton Ave
Bethlehem, PA 18018
Phone (610) 954-3012

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

807 Lawn Ave
Sellersville, PA 18960

Interoperability endpoints

  • Direct secure messaging: roy.kaushik@slpg.direct-sluhn.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518912000000",
    "number": "1205234754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 VAN WYCK EXPRESSWAY",
            "address_2": "JAMAICA HOSPITAL MEDICAL CENTER",
            "address_purpose": "LOCATION",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11418",
            "country_code": "US",
            "telephone_number": "718-206-6000 x7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "KAUSHIK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-16",
        "last_updated": "2018-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "056652",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "056652",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.