Organization Active NPI

Patricia Roy D.O. PC

  • Family Medicine Physician
  • Muskegon, MI
National Provider Identifier
1851307490
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101008446 Issued in MI
Legal business name
PATRICIA ROY D.O. PC
Practice address
1864 Lakeshore Dr
Muskegon, MI 49441-1607
Phone
(231) 755-1648
Fax
(231) 755-5279
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Dr. Patricia Roy, D.O.NPI 1770580045
Title
Physician
Phone
(231) 755-1648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5101008446 MI Primary

Addresses

Primary practice location

1864 Lakeshore Dr
Muskegon, MI 49441-1607

Mailing address

1864 Lakeshore Dr
Muskegon, MI 49441-1607
Phone (231) 755-1648

Other identifiers 1

IdentifierTypeStateIssuer
2307827MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070604000441 MI Part B Supplier - Clinic/Group Practice 0941308639 Receives reassigned benefits from 2 practitioners
Practice locations: Muskegon, MI

National Provider Directory

National Provider Directory

Locations

1864 Lakeshore Dr
Muskegon, MI 49441
Phone (231) 755-1628

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1851307490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 LAKESHORE DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411607",
            "telephone_number": "231-755-1648",
            "fax_number": "231-755-5279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 LAKESHORE DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411607",
            "telephone_number": "231-755-1648",
            "fax_number": "231-755-5279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA ROY D.O. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "231-755-1648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101008446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2307827",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.