Organization Active NPI

Roy Elevazo & Associates, Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakewood, CA
National Provider Identifier
1346924420
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ROY ELEVAZO & ASSOCIATES, INC.
Practice address
5220 Clark Ave Ste 400
Lakewood, CA 90712-2625
Phone
(562) 804-3575
Fax
(562) 286-8123
NPI assigned
Jun 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Roy Allan O Elevazo, MSN, PMHNP-BCNPI 1427489483
Title
President/Ceo
Phone
(562) 804-3575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

5220 Clark Ave Ste 400
Lakewood, CA 90712-2625

Mailing address

3553 Atlantic Ave # 253
Long Beach, CA 90807-5606
Phone (562) 684-8134

Other names 1

  • Royal Institute of Psychiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230814001668 CA Part B Supplier - Clinic/Group Practice 0547622193 Receives reassigned benefits from 2 practitioners
Practice locations: Lakewood, CA

National Provider Directory

National Provider Directory

Locations

5220 Clark Ave
Ste 400
Lakewood, CA 90712
Phone (562) 804-3575

5220 Clark Ave
Lakewood, CA 90712
Phone (562) 735-4037

3553 Atlantic Ave
#253
Long Beach, CA 90807
Phone (562) 804-3575

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1346924420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 ATLANTIC AVE # 253",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908075606",
            "telephone_number": "562-684-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 CLARK AVE STE 400",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122625",
            "telephone_number": "562-804-3575",
            "fax_number": "562-286-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY ELEVAZO & ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "ELEVAZO",
        "authorized_official_first_name": "ROY ALLAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "562-804-3575",
        "authorized_official_credential": "MSN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Institute of Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.