Individual provider Active NPI

Anand Krishnalal Roy, M.D.

  • Internal Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1366424905
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10341 R Issued in LA
Practice address
760 East Bayou Pines
Lake Charles, LA 70601-7184
Phone
(337) 433-0313
Fax
(337) 433-0554
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 10341 R LA Primary

Addresses

Primary practice location

760 East Bayou Pines
Lake Charles, LA 70601-7184

Mailing address

760 East Bayou Pines
Lake Charles, LA 70601-7184
Phone (337) 433-0313

Other identifiers 3

IdentifierTypeStateIssuer
49589780107OtherLAME
1989614MedicaidLA
10341ROtherLASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080116000029 LA Practitioner - Internal Medicine 8426139494

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10341 RLAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366424905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 EAST BAYOU PINES",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017184",
            "telephone_number": "337-433-0313",
            "fax_number": "337-433-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 EAST BAYOU PINES",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017184",
            "telephone_number": "337-433-0313",
            "fax_number": "337-433-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "ANAND",
        "middle_name": "KRISHNALAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "10341 R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME",
            "identifier": "49589780107",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1989614",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10341R",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.