Active NPI
Kevin Jonathan Roy, DPM
- Podiatrist
- Bronx, NY
National Provider Identifier
1871001818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 003515
- Practice address
- 5958 Delafield Ave
Bronx, NY 10471-1608 - Phone
- (914) 512-0938
- NPI assigned
- Jan 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 25MD00152500 | NJ | |
| Podiatrist | 213E00000X | 003515 | NY | Primary |
Addresses
Primary practice location
5958 Delafield Ave
Bronx, NY 10471-1608
Mailing address
5958 Delafield Ave
Bronx, NY 10471-1608
Phone (914) 512-0938
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MD00152500 | Other | NJ | STATE LICENSE |
| 003515 | Other | NY | LICENSE |
| 3090 | Other | CA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MD00152500 | NJ | MD | Podiatrist |
| 003515 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1871001818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5958 DELAFIELD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104711608",
"telephone_number": "914-512-0938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5958 DELAFIELD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104711608",
"telephone_number": "914-512-0938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "KEVIN",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-11",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NJ",
"license": "25MD00152500",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "003515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "25MD00152500",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "003515",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "3090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.