Individual provider Active NPI

Richard A. Roy, M.D.

  • Urology Physician
  • Columbus, OH
National Provider Identifier
1366449464
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35-06-0013-R Issued in OH
Practice address
3100 Plaza Properties Blvd
Suite 320
Columbus, OH 43219-1531
Phone
(614) 751-1010
Fax
(614) 751-4692
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35060013 OH
Urology Physician 208800000X 35-06-0013-R OH Primary

Addresses

Primary practice location

3100 Plaza Properties Blvd
Suite 320
Columbus, OH 43219-1531

Mailing address

3100 Plaza Properties Blvd
Suite 320
Columbus, OH 43219-1531
Phone (614) 751-1010

Other practice location 1

1980 Tamarack Rd
Newark, OH 43055-1363
Phone (220) 564-7521

Other practice location 2

1980 Tamarack Rd
Newark, OH 43055-1363
Phone (220) 564-7521

Other identifiers 2

IdentifierTypeStateIssuer
0792049MedicaidOH
0347841OtherOHRAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rroy26299@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION
Direct Messaging Address rroy26299@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060803000280 OH Practitioner - Urology 0446263933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

1980 Tamarack Rd
Newark, OH 43055-1363
Phone (220) 564-7520

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35060013OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corporation CurrentSince Nov 19, 2021 Accepting new patients
Licking Memorial Health Professionals Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Nov 19, 2021 Accepting new patients

Locations

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1980 Tamarack Rd
Newark, OH 43055
Phone (220) 564-7520

Organizations & group practices 3

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 1

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1366449464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 PLAZA PROPERTIES BLVD",
            "address_2": "SUITE 320",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191531",
            "telephone_number": "614-751-1010",
            "fax_number": "614-751-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PLAZA PROPERTIES BLVD",
            "address_2": "SUITE 320",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191531",
            "telephone_number": "614-751-1010",
            "fax_number": "614-751-4692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1980 Tamarack Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551363",
            "country_code": "US",
            "telephone_number": "220-564-7521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1980 Tamarack Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551363",
            "country_code": "US",
            "telephone_number": "220-564-7521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "RICHARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35060013",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35-06-0013-R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0792049",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0347841",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rroy26299@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1980 Tamarack Rd",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rroy26299@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1980 Tamarack Rd",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.