Individual provider Active NPI

Crystal L Roy, PA

  • Physician Assistant
  • Urbana, IL
National Provider Identifier
1275965220
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.004731 Issued in IL
Practice address
611 W. Park St
Urbana, IL 61801
Phone
(309) 530-5101
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.004731 IL Primary

Addresses

Primary practice location

611 W. Park St
Urbana, IL 61801

Mailing address

611 W. Park St
Fapc
Urbana, IL 61801
Phone (309) 530-5101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140103000023 IL Practitioner - Physician Assistant 9537397203 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Community Health Improvement CenterGroup PAC ID 4385625342, 13 clinicians

Practice addresses (Care Compare)

1701 W Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6200

1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9500

320 E Central Ave
Decatur, IL 62521-4665
Phone (217) 877-9117

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.004731ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Aug 12, 2023 Accepting new patients
Community Health Improvement Center CurrentSince Feb 20, 2016 Accepting new patients
Community Health Improvement Center CurrentSince Feb 20, 2016 Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 8, 2019 Accepting new patients
Hoopeston Community Memorial Hospital Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

1701 Curtis Rd
Champaign, IL 61822
Phone (217) 365-6201

243 W Cerro Gordo St
Decatur, IL 62522
Phone (217) 422-3940

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

2905 N Main St
Decatur, IL 62526
Phone (217) 877-9117

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590

1818 E Windsor Rd
Urbana, IL 61802
Phone (217) 255-9646

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: croypa265462@carlehiedirect.net
  • Direct secure messaging: crystal.alvey.p31@direct.fhn-fqhc.nextgenshare.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1275965220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "309-530-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "309-530-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2024-02-08",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.