Organization Active NPI

S D Roy MD Inc

  • Internal Medicine Physician
  • Elyria, OH
National Provider Identifier
1891841086
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35075700 Issued in OH
Legal business name
S D ROY MD INC
Practice address
125 E Broad St
Suite #122
Elyria, OH 44035-6400
Phone
(440) 329-7350
NPI assigned
Jan 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Somnath Roy, M.D.
Title
President
Phone
(440) 329-7350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 35075700 OH Primary

Addresses

Primary practice location

125 E Broad St
Suite #122
Elyria, OH 44035-6400

Mailing address

125 E Broad St
Suite #122
Elyria, OH 44035-6400
Phone (440) 329-7350

Other identifiers 2

IdentifierTypeStateIssuer
2843810MedicaidOH
2135415MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1891841086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "SUITE #122",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "SUITE #122",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S D ROY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "SOMNATH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-329-7350",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35075700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2843810",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2135415",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.