Individual provider Active NPI

Mary N Roy, MD

  • Diagnostic Radiology Physician
  • Paoli, PA
National Provider Identifier
1710060488
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD038157E Issued in PA
Practice address
255 W Lancaster Ave
Paoli, PA 19301-1763
Phone
(610) 648-1000
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD038157E PA Primary

Addresses

Primary practice location

255 W Lancaster Ave
Paoli, PA 19301-1763

Mailing address

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (610) 648-1000

Other identifiers 4

IdentifierTypeStateIssuer
0129407604OtherPAAMERICHOICE
0459431000OtherPAKEYSTONE HEALTHPLAN EAST
629588OtherPABLUE SHIELD PA
0012940760005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100621000798 PA Practitioner - Diagnostic Radiology 1658402573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Pennsylvania, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-2263

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3120
Phone (484) 337-4371

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (484) 227-3005

120 Valley Green LN
King of Prussia, PA 19406-2079
Phone (866) 225-5654

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-4123

154 Exton Square Mall
Exton, PA 19341-2440
Phone (484) 565-8590

1991 Sproul Rd
Broomall, PA 19008-3512
Phone (484) 476-3700

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-1596

3855 W Chester Pike
Newton Square, PA 19073-2304
Phone (484) 337-6149

599 Arcola Rd
Collegeville, PA 19426-3954
Phone (484) 565-8430

80 Lancaster Ave
Devon, PA 19333-1331
Phone (484) 526-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of the Main Line P C Diagnostic Radiology CurrentSince Nov 19, 1990 Accepting new patients
Main Line Health Imaging LP Diagnostic Radiology CurrentSince Jan 2, 2002 Accepting new patients
Main Line Healthcare PastSince Jul 31, 2010 Accepting new patients

Locations

1991 Sproul Rd
Broomall, PA 19008
Phone (484) 476-3700

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 526-2200

130 S Bryn Mawr Ave
Fl 2
Bryn Mawr, PA 19010
Phone (610) 526-3000

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

599 Arcola Rd
Collegeville, PA 19426
Phone (484) 565-8440

154 Exton Square Mall
Exton, PA 19341
Phone (484) 565-8500

1020 Baltimore Pike
Glen Mills, PA 19342
Phone (484) 227-7777

120 Valley Green Ln
Kng of Prussa, PA 19406
Phone (610) 526-3000

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

3855 West Chester Pike
Newtown Square, PA 19073
Phone (484) 337-6000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

306 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 476-7222

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 6

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1710060488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "610-648-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "610-648-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "MARY",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD038157E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0129407604",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTHPLAN EAST",
            "identifier": "0459431000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PA",
            "identifier": "629588",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012940760005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.