Individual provider Active NPI

Gregory Michael Roybal, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1780734491
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A55881 Issued in CA
Practice address
245 S Fetterly Ave
Room 2277
Los Angeles, CA 90022-1605
Phone
(323) 780-2216
Fax
(323) 264-3771
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A55881 CA Primary

Addresses

Primary practice location

245 S Fetterly Ave
Room 2277
Los Angeles, CA 90022-1605

Mailing address

245 S Fetterly Ave
Room 2277
Los Angeles, CA 90022-1605
Phone (323) 780-2216

Other identifiers 1

IdentifierTypeStateIssuer
WA55881BMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141008002232 CA Practitioner - Internal Medicine 3274753546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

12021 S Wilmington Ave
Room 1059
Los Angeles, CA 90059-3019

245 S Fetterly Ave
Los Angeles, CA 90022-1605
Phone (323) 780-2216

Hospital & facility affiliations

  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373
  • Lac/Rancho Los Amigos National Rehabilitation Ctr Hospital, Downey, CA, CCN 050717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55881CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

Organizations & group practices 1

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 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780734491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "address_2": "ROOM 2277",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-780-2216",
            "fax_number": "323-264-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "address_2": "ROOM 2277",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-780-2216",
            "fax_number": "323-264-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYBAL",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WA55881B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.