Jacob L Conroy

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

5151015440 Issued in MI

Practice address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Phone

(248) 898-2673

NPI assigned

Apr 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1801477922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-2673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Cold Spring Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462221960",
            "country_code": "US",
            "telephone_number": "124-839-0287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONROY",
        "first_name": "JACOB",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "5151015440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Conley, D.D.S.
• Kelsey Lynn Conn, CNM
• Logan Conner, MD
• David Joseph Connolly, DO
• Patricia Ann Connor, NP
• Patrick Conroy, PA-C
• Sinziana Constantinescu, DO
• Paul James Constantino, D.P.M.
• Ian Conway
• Andrew Cook, MD

• Vascular & Interventional Radiology Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Vascular & Interventional Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.