Active NPI
Martin Roybal, CRNA
- Certified Registered Nurse Anesthetist
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 136489
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 721-2273
- NPI assigned
- Jan 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 136489 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
3021 Brockham CT
Augusta, GA 30909-0629
Phone (404) 934-1715
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Medical College of Georgia School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623
4300 University Pkwy
Evans, GA 30809-3063
Phone (706) 721-8623
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171
Hospital & facility affiliations
- Wellstar MCG Health, Affiliated With Med Col
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136489 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Southern Anesthesia of Augusta LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Anesthesia Billing Services, LLC | Current | Accepting new patients | |
| Anesthesia Consultants of Augusta, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Southern Anesthesia of Augusta LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
915 Russell St
Augusta, GA 30904
Phone (706) 737-4255
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
905 Stevens Creek Rd
Augusta, GA 30907
Phone (706) 722-3458
3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232
635 Ronald Reagan Dr
Evans, GA 30809
Phone (706) 868-3100
4300 University Pkwy
Evans, GA 30809
Phone (706) 721-8614
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
462 Furys Ferry Rd
Martinez, GA 30907
Phone (706) 868-0319
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Anesthesiology Physician
- Augusta, GA
- NPI 1881877793
-
- Anesthesiology Physician
- Augusta, GA
- NPI 1801843933
-
- Certified Registered Nurse Anesthetist
- Augusta, GA
- NPI 1356706709
Nurse Anesthetist, Certified Registered
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Austell, GA
- NPI 1942593959
-
- Certified Registered Nurse Anesthetist
- Aiken, SC
- NPI 1407638224
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1437135902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1558022046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3021 BROCKHAM CT",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309090629",
"telephone_number": "404-934-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYBAL",
"first_name": "MARTIN",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-06",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "136489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.