NPIMap

Individual provider Active NPI

Prakash N Roy, M.D.

  • Nephrology Physician
  • Poland, OH
National Provider Identifier
1992754808
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-090547 Issued in OH
Practice address
807 Southwestern Run
Poland, OH 44514-3688
Phone
(330) 729-0059
Fax
(330) 729-9297
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-090547 OH Primary

Addresses

Primary practice location

807 Southwestern Run
Poland, OH 44514-3688

Mailing address

807 Southwestern Run
Poland, OH 44514-3688
Phone (330) 729-0059

Other identifiers 1

IdentifierTypeStateIssuer
91175934813MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080111000260 OH Practitioner - Internal MedicinePractitioner - Nephrology 7113911579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates, Inc.Group PAC ID 0840227674, 4 clinicians

Practice addresses (Care Compare)

807 Southwestern Run
Poland, OH 44514-3688
Phone (330) 729-0059

Hospital & facility affiliations

  • FMC - Salem South Dialysis facility, Salem, OH, CCN 362562
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
  • Salem Regional Medical Center Hospital, Salem, OH, CCN 360185
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352

Merit-based Incentive Payment System (MIPS)

Final score
22.09 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-090547OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates, Inc. Nephrology Current Accepting new patients

Locations

807 Southwestern Run
Youngstown, OH 44514
Phone (330) 729-0059

Interoperability endpoints

  • Direct secure messaging: proy35237@direct.bsmhealth.org
  • Direct secure messaging: proy23147@direct.acumenmd.com

Organizations & group practices 2

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.

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1992754808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 SOUTHWESTERN RUN",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143688",
            "telephone_number": "330-729-0059",
            "fax_number": "330-729-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 SOUTHWESTERN RUN",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143688",
            "telephone_number": "330-729-0059",
            "fax_number": "330-729-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "PRAKASH",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-090547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91175934813",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.