Individual provider Active NPI

Michael Patrick Royalty, M.D.

  • Anesthesiology Physician
  • Newburgh, IN
National Provider Identifier
1508190281
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01069124A Issued in IN
Practice address
4199 Gateway Blvd
Department of Anesthesiology
Newburgh, IN 47630-8940
Phone
(812) 842-4200
Fax
(812) 473-5822
NPI assigned
Sep 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 01069124A IN
Interventional Pain Medicine Physician 208VP0014X 01069124A IN
Anesthesiology Physician 207L00000X 01069124A IN Primary

Addresses

Primary practice location

4199 Gateway Blvd
Department of Anesthesiology
Newburgh, IN 47630-8940

Mailing address

PO Box 637275
Cincinnati, OH 45263-7275
Phone (812) 473-0181

Other identifiers 2

IdentifierTypeStateIssuer
201106200MedicaidIN
7100275020MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dhs@direct.deaconess.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20131202000062 IN Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 9133267271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
University of Cincinnati College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4199 Gateway Blvd
Newburgh, IN 47630-8940
Phone (812) 842-4200

Hospital & facility affiliations

  • The Women'S Hospital Hospital, Newburgh, IN, CCN 150149
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01069124AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Women'S Hospital of Southern Indiana, LLC CurrentSince Feb 1, 2016 Accepting new patients
Deaconess Women'S Hospital of Southern Indiana, LLC Anesthesiology CurrentSince Feb 1, 2016 Accepting new patients
Guernsey Anesthesia Associates, Inc. Past Accepting new patients

Locations

4199 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-4200

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 3

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1508190281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637275",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637275",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 GATEWAY BLVD",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308940",
            "telephone_number": "812-842-4200",
            "fax_number": "812-473-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYALTY",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-28",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IN",
            "license": "01069124A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01069124A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01069124A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201106200",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100275020",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhs@direct.deaconess.com",
            "affiliation": "N",
            "address_1": "4199 Gateway Blvd",
            "address_2": "Department of Anesthesiology",
            "city": "Newburgh",
            "state": "IN",
            "country_code": "US",
            "postal_code": "476308940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.