Individual provider Active NPI

Saswata Roy, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1801902739
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
ME92036 Issued in FL
Practice address
11705 San Jose Blvd
Ste 103
Jacksonville, FL 32223-1835
Phone
(904) 880-0911
Fax
(904) 880-9388
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X ME92036 FL
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X ME92036 FL Primary

Addresses

Primary practice location

11705 San Jose Blvd
Ste 103
Jacksonville, FL 32223-1835

Mailing address

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Other identifiers 1

IdentifierTypeStateIssuer
271475200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050111000374 FL Practitioner - Otolaryngology 1850349366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Nebraska College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

11705 San Jose Blvd
Suite 103
Jacksonville, FL 32223-1653
Phone (904) 880-0911

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME92036FLMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Sep 1, 2013 Accepting new patients
North Florida Surgeons, PA CurrentSince Sep 1, 2013 Accepting new patients
Charles C Greene MD PHD PA PastSince Jan 15, 2013 Accepting new patients

Locations

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

4203 Belfort Rd
Ste 340
Jacksonville, FL 32216
Phone (904) 880-0911

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11705 San Jose Blvd
Ste 103
Jacksonville, FL 32223
Phone (904) 880-0911

75 Jaidev Rd
Ste 200
St Johns, FL 32259
Phone (904) 880-0911

Interoperability endpoints

  • Direct secure messaging: saswata.roy.1@9109.direct.athenahealth.com

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 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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1801902739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD",
            "address_2": "STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 SAN JOSE BLVD",
            "address_2": "STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231835",
            "telephone_number": "904-880-0911",
            "fax_number": "904-880-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "SASWATA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME92036",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME92036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271475200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.