Individual provider Active NPI

Haley G Roy, FNP

  • Family Medicine Physician
  • Folsom, CA
National Provider Identifier
1538940374
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NP95027086 Issued in CA
Practice address
1615 Creekside Dr
Folsom, CA 95630-3491
Phone
(916) 817-4132
NPI assigned
Oct 9, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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 NP95027086 CA Primary

Addresses

Primary practice location

1615 Creekside Dr
Folsom, CA 95630-3491

Mailing address

1659 Sunningdale Dr
Roseville, CA 95747-5821
Phone (916) 719-2420

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240113000801 CA Practitioner - Nurse Practitioner 9335591452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gina Tobalina MD IncGroup PAC ID 7012167281, 5 clinicians

Practice addresses (Care Compare)

1615 Creekside Dr
Suite 101
Folsom, CA 95630-3491
Phone (916) 803-2602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95027086CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gina Tobalina MD Inc Family Medicine CurrentSince Oct 30, 2023 Accepting new patients
Kawanaa D Carter M D Inc PastSince Oct 30, 2023 Accepting new patients

Locations

1615 Creekside Dr
Ste 101
Folsom, CA 95630
Phone (916) 803-2602

Interoperability endpoints

  • Direct secure messaging: hroy175790@hpmg.direct-ci.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1538940374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 SUNNINGDALE DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475821",
            "telephone_number": "916-719-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 CREEKSIDE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303491",
            "telephone_number": "916-817-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "HALEY",
        "middle_name": "G",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "NP95027086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.