Active NPI
Simon Fortin Roy, M.D.
- Anatomic Pathology Physician
- New Haven, CT
National Provider Identifier
1588397004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 01087143A
- Practice address
- 20 York St (Yale New Haven Hospital)
New Haven, CT 06510 - Phone
- (203) 688-4242
- NPI assigned
- Jul 1, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 01087143A | IN | Primary |
Addresses
Primary practice location
20 York St (Yale New Haven Hospital)
New Haven, CT 06510
Mailing address
28 Chemin de la Vallee
Chelsea, QUEBEC J9B1M3
CA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01087143A | IN | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675987200000",
"number": "1588397004",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "28 CHEMIN DE LA VALLEE",
"city": "CHELSEA",
"state": "QUEBEC",
"postal_code": "J9B1M3"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK ST (YALE NEW HAVEN HOSPITAL)",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06510",
"telephone_number": "203-688-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "SIMON FORTIN",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-01",
"last_updated": "2023-02-10",
"certification_date": "2023-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "IN",
"license": "01087143A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.