Individual provider Active NPI

Marilyn Roy, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1710437611
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6457 Issued in AZ
Practice address
5929 Balcones Dr Ste 200
Austin, TX 78731-4280
Phone
(512) 222-5856
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6457 AZ Primary

Addresses

Primary practice location

5929 Balcones Dr Ste 200
Austin, TX 78731-4280

Mailing address

11500 Catalonia Dr
Austin, TX 78759-4913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161024002408 AZ Practitioner - Physician Assistant 7618255795 Reassigns benefits to 1 organization
I20230703001244 TX Practitioner - Physician Assistant 7618255795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Midwestern University College of Dental Medicine, Glendale, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Sinus and Allergy Specialists of TexasGroup PAC ID 7315169596, 41 clinicians

Practice addresses (Care Compare)

115 N Loop 1604 E
1204 Texan Allergy
San Antonio, TX 78232-1399
Phone (512) 550-1800

12801 Shops Pkwy
Suite 400
Bee Caves, TX 78738-6446
Phone (512) 222-5856

401 W Slaughter LN
Suite 300
Austin, TX 78748-1774
Phone (512) 550-1800

5656 Bee Caves Rd
Suite C104
West Lake Hills, TX 78746-5281
Phone (512) 222-5856

7125 New Sanger Ave
504 Texan Allergy
Waco, TX 76712-4054
Phone (512) 550-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6457AZMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Nextcare Arizona I JV LLC Current Accepting new patients

Locations

2080 W Southern Ave
Bldg A1
Apache Junction, AZ 85120
Phone (480) 985-0172

13075 W McDowell Rd
Ste D106
Avondale, AZ 85392
Phone (623) 547-0522

450 S Willard St
Ste 120
Cottonwood, AZ 86326
Phone (928) 634-2574

1000 N Humphreys St
Ste 104
Flagstaff, AZ 86001
Phone (928) 779-3844

914 N Scottsdale Rd
Ste 104
Tempe, AZ 85288
Phone (480) 776-1620

9525 E Old Spanish Trl
Ste 101
Tucson, AZ 85748
Phone (520) 731-3666

1394 W 16th St
Yuma, AZ 85364
Phone (928) 539-0055

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.

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1710437611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 CATALONIA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 BALCONES DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314280",
            "telephone_number": "512-222-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "MARILYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.