NPIMap

Individual provider Active NPI

Somdev Roy, MD

  • Hematology & Oncology Physician
  • Mt Pleasant, MI
National Provider Identifier
1851322747
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301058423 Issued in MI
Practice address
1221 South Dr
Mt Pleasant, MI 48858-3258
Phone
(989) 772-6811
Fax
(989) 772-6813
NPI assigned
Jul 6, 2006
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4301058423 MI Primary

Addresses

Primary practice location

1221 South Dr
Mt Pleasant, MI 48858-3258

Mailing address

1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-5786

Other identifiers 1

IdentifierTypeStateIssuer
4426849MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000880 MI Practitioner - Hematology/OncologyPractitioner - Medical Oncology 1557542305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Thumb RegionGroup PAC ID 6800709221, 39 clinicians

Practice addresses (Care Compare)

1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9521

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301058423MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Caro Region CurrentSince Jun 9, 2021 Accepting new patients
McLaren Thumb Region CurrentSince Jun 5, 2021 Accepting new patients
Huron Pathology Services PC Current Accepting new patients
McLaren Thumb Region Current Accepting new patients
McLaren Thumb Region CurrentSince Jun 5, 2021 Accepting new patients
McLaren Caro Region CurrentSince Jun 9, 2021 Accepting new patients

Locations

1100 S Van Dyke Rd
Bad Axe, MI 48413
Phone (989) 269-9521

401 N Hooper St
Caro, MI 48723
Phone (517) 673-3141

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1851322747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139615",
            "telephone_number": "989-269-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SOUTH DR",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583258",
            "telephone_number": "989-772-6811",
            "fax_number": "989-772-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "SOMDEV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301058423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4426849",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.