Roy Allan O Elevazo, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95000309 Issued in CA

Practice address

5220 Clark Ave Ste 400
Lakewood, CA 90712-2625

Phone

(562) 804-3575

Fax

(562) 286-8123

NPI assigned

Dec 2, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roy Elevazo & Associates, Inc.

  dba Royal Institute of Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakewood, CA
  • NPI 1346924420
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1427489483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 ATLANTIC AVENUE #253",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90807",
            "telephone_number": "562-804-3575"
        },
        {
            "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": {
        "last_name": "ELEVAZO",
        "first_name": "ROY ALLAN",
        "middle_name": "O",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-02",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95000309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsie Edson
• Daniel Edu
• Ehab Samaan DDS,Inc
• Isaac Eisenstein, M.D.
• Maranina Mary Eister
• Anna Teresa Macalalad Eliseo, RN
• Devin Dejon Ellis, D.D.S
• Empire Wellness Mental Health Group
• Empire Wellness, LLC
• End of Shift Management Group Inc

• Psychiatric/Mental Health Nurse Practitioner in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.