Individual provider Active NPI

Roy Harris, M.D.

  • Family Medicine Physician
  • Sylmar, CA
National Provider Identifier
1467589333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A52578 Issued in CA
Practice address
14445 Olive View Dr
North Annex
Sylmar, CA 91342-1437
Phone
(818) 364-3244
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

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
Family Medicine Physician 207Q00000X A52578 CA Primary

Addresses

Primary practice location

14445 Olive View Dr
North Annex
Sylmar, CA 91342-1437

Mailing address

PO Box 472
Glendale, CA 91209-0472
Phone (818) 364-3244

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150930003028 CA Practitioner - Internal Medicine 7911215595 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52578CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Aug 9, 2015 Accepting new patients
County of Los Angeles CurrentSince Aug 9, 2015 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467589333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 472",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912090472",
            "telephone_number": "818-364-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "NORTH ANNEX",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A52578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.