Individual provider Active NPI

Cassandra Roy, NP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1790318525
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95029510 Issued in CA
Practice address
5145 N California Ave Ste 331
Chicago, IL 60625-3661
Phone
(773) 878-8200
Fax
(773) 293-4171
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209025207 IL
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 026359 OH
Nurse Practitioner 363L00000X 95029510 CA Primary

Addresses

Primary practice location

5145 N California Ave Ste 331
Chicago, IL 60625-3661

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 982-6715

Other practice location 1

4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 473-3561

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614002949 CA Practitioner - Nurse Practitioner 1153752746 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians
UCSF Health Medical FoundationGroup PAC ID 9436239878, 65 clinicians

Practice addresses (Care Compare)

1900 Sullivan Ave
Daly City, CA 94015-2200
Phone (650) 992-4000

199 W Portal Ave
San Francisco, CA 94127-1305
Phone (415) 821-8798

2288 Market St
San Francisco, CA 94114-1506
Phone (415) 964-4855

325 Gellert Blvd
Daly City, CA 94015-2613
Phone (650) 270-2394

3838 California St
RM 111
San Francisco, CA 94118-1504
Phone (415) 221-6476

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3000

750 Redwood Hwy Frontage Rd
Suite 1204
Mill Valley, CA 94941-2483
Phone (415) 384-4778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95029510CAMDNurse Practitioner
026359OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Solano Gateway Medical Group Inc Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
UCSF Health Medical Foundation Single Specialty CurrentSince Nov 5, 2024 Accepting new patients
Cep America-California CurrentSince Dec 11, 2024 Accepting new patients
City Health, a Medical Corporation Single Specialty CurrentSince Dec 31, 2024 Accepting new patients
Cep America - California Single Specialty CurrentSince Dec 11, 2024 Accepting new patients
Cep America - California Single Specialty Current Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Yoshihiro Katsuura Professional Corporation Single Specialty PastSince Apr 15, 2023 Accepting new patients

Locations

1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503

401 Cypress St
Fort Bragg, CA 95437
Phone (415) 697-8659

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

3838 California St
Rm 111
San Francisco, CA 94118
Phone (415) 221-6476

2395 Lombard St
San Francisco, CA 94123
Phone (415) 640-5024

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

201 Dolores Ave
San Leandro, CA 94577
Phone (510) 984-2489

13690 E 14th St
Ste 100
San Leandro, CA 94578
Phone (510) 984-2489

5145 N California Ave
Ste 331
Chicago, IL 60625
Phone (847) 570-1027

Interoperability endpoints

  • Direct secure messaging: croy392664@direct-ucsfmedicalcenter.org

Organizations & group practices 8

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 1

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1790318525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE STE 331",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4235 Secor Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436234231",
            "country_code": "US",
            "telephone_number": "419-473-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "CASSANDRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209025207",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "026359",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.