Individual provider Active NPI

Tristan Roy, PA-C

  • Physician Assistant
  • Newport, VT
National Provider Identifier
1992588149
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
189 Prouty Dr
Newport, VT 05855-9326
Phone
(902) 334-7331
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

189 Prouty Dr
Newport, VT 05855-9326

Mailing address

189 Prouty Dr
Newport, VT 05855-9820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307000850 VT Practitioner - Physician Assistant 7517303076 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Hospital & Health Center Inc CurrentSince Feb 5, 2024 Accepting new patients
North Country Hospital & Health Center Inc Current Accepting new patients
North Country Hospital & Health Center Inc Current Accepting new patients
Springfield Hospital .Inc CurrentSince May 25, 2025 Accepting new patients
North Country Hospital & Health Center Inc CurrentSince Feb 5, 2024 Accepting new patients
Springfield Hospital CurrentSince May 25, 2025 Accepting new patients

Locations

186 Medical Village Dr
#1
Newport, VT 05855
Phone (802) 334-3262

189 Prouty Dr
Newport, VT 05855
Phone (802) 334-3569

186 Medical Village Dr
Newport, VT 05855
Phone (802) 334-3520

25 Ridgewood Rd
Springfield, VT 05156
Phone (780) 281-9593

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4a15a283-6747-4ef7-984f-ce0e904fd6f0/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1992588149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PROUTY DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 PROUTY DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559326",
            "telephone_number": "902-334-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "TRISTAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, VT

Sources for this page

Verify at the official NPI Registry.