NPIMap

Individual provider Active NPI

Renee Roy, MD

  • Family Medicine Physician
  • Del City, OK
National Provider Identifier
1649200361
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18864 Issued in OK
Practice address
3851 Tinker Diagonal
Del City, OK 73115-2109
Phone
(405) 632-6688
NPI assigned
Jul 5, 2006
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 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 18864 OK Primary

Addresses

Primary practice location

3851 Tinker Diagonal
Del City, OK 73115-2109

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Other identifiers 1

IdentifierTypeStateIssuer
100108710AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX, PA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050812000176 OK Practitioner - Family Practice 2860446259 Reassigns benefits to 1 organization
I20161215000415 TX Practitioner - Family Practice 2860446259 Reassigns benefits to 1 organization
I20170410000909 PA Practitioner - Emergency MedicinePractitioner - Family Practice 2860446259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Family Clinic LLCGroup PAC ID 7517277114, 3 clinicians

Practice addresses (Care Compare)

3717 S Western Ave
Oklahoma City, OK 73154-3401
Phone (405) 601-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18864OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Nov 1, 2018 Accepting new patients
Southern Plains Medical Center Inc CurrentSince Jul 5, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince Nov 1, 2018 Accepting new patients
My Family Clinic LLC Family Medicine CurrentSince Dec 1, 2015 Accepting new patients
Lawton Indian Hospital CurrentSince Aug 25, 2020 Accepting new patients
Southern Plains Medical Center Inc CurrentSince Jul 5, 2022 Accepting new patients
Pinnacle Health Medical Services Family Medicine Current Accepting new patients
Southern Plains Medical Center Inc Current Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2222 W Iowa Ave
Chickasha, OK 73018

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

3717 S Western Ave
Oklahoma City, OK 73109
Phone (405) 601-6000

106 Burr Ave
Pauls Valley, OK 73075
Phone (405) 238-4633

1404 Baltimore St
Ste 4
Hanover, PA 17331
Phone (717) 637-0470

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

300 W King St
Littlestown, PA 17340
Phone (717) 359-9214

Interoperability endpoints

  • Direct secure messaging: rroy658335@direct.ochin.org

Organizations & group practices 11

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.

Hospital & facility affiliations 9

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1649200361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 TINKER DIAGONAL",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731152109",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "18864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108710A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del City, OK

Sources for this page

Verify at the official NPI Registry.