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ROY M JOSEPH MD
NPI 1205864667
Internal Medicine - Gastroenterology in Denton, TX

Active since June 28, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 45D0963318 · Waiver
79.87/100
CMS Quality Rating
3201 TEASLEY LN STE 202, DENTON, TX 76210(940) 243-7200(940) 565-1577 Get Directions Write a Review

NPPES record last updated: November 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 21, 2024, Sep 21, 2020 (2 updates tracked since 2020).

About Roy M Joseph Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROY M JOSEPH MD (NPI 1205864667) is an individual gastroenterology provider in Denton, Texas, licensed in Texas (K3266) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through July 26, 2027, and is affiliated with Medical City Denton.

NPPES Registry Identity

NPI1205864667
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameROY M JOSEPHCredential: MD
Location Address3201 TEASLEY LN STE 202Denton, TX 76210-8304
Mailing AddressPo Box 35629Dallas, TX 75235-0629 · (214) 424-2200 · Fax (214) 231-2159
Phone(940) 243-7200
Fax(940) 565-1577
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateJune 28, 2006
Last NPPES UpdateNovember 21, 20242 updates tracked since enumeration
NPPES CertifiedNovember 21, 2024
✔ NPI 1205864667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in TX · K3266
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
3201 TEASLEY LN STE 202, Denton, TX 76210
Open in Google Maps ↗

Secondary Practice Location 1

Location 13324 Colorado Bouvelard, Suite 101Denton, TX 76210 · Phone (940) 243-7200 · Fax (940) 565-1577

Other Identifiers 3

Other0029CHTX · Bc/bs
Medicaid214637501TX
Medicaid029534701TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roy M Joseph Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032177605
PECOS Enrollment IDI20041229000436
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Roy Joseph reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Texas Digestive Disease Consultants, PLLC
9.3 mi
Gastroenterology
4370 MEDICAL ARTS DR STE 295
Flower Mound, TX 75028
  • Reassigned Medicare billing, Texas enrollment
  • 575 clinicians in this Medicare group
NPI 1689650475 (972) 691-3777

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0963318

Roy M Joseph MD PA · Denton, TX
Active · expires Jul 26, 2027
CLIA Number45D0963318
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2025
Certificate Expiration DateJuly 26, 2027
Laboratory DirectorRoy M. Joseph
Laboratory Phone(940) 243-7200
Laboratory LocationRoy M Joseph MD PA3324 Colorado Blvd, Suite 101, Denton, TX 76210
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
238 services145 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
108 services107 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
89 services79 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
58 services56 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
37 services37 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
21 services21 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Medical City Denton

Acute Care Hospitals · Denton, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450634
Location3535 South I35 EastDenton, TX 76210 · Denton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.55
Promoting Interoperability100
Improvement Activities40
Cost64.36

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
99%574 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,952 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
60%954 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
96%473 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
6%362 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
81%1,200 patients4/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
65%467 patients3/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
95%362 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
35%362 patients2/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
3 suppliers12 claims360 services$6.12 avg. paid by Medicare
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4153
Other-Enteral and Parenteral · category OB006N
3 suppliers12 claims5,136 services$1.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roy Joseph's NPI number?

The NPI number for Roy Joseph is 1205864667. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Roy Joseph located?

Roy Joseph practices at 3201 Teasley Ln Ste 202, Denton, TX 76210. The listed phone number is (940) 243-7200.

What is Roy Joseph's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Roy Joseph enrolled in Medicare?

Yes. Roy Joseph is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Roy Joseph's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roy Joseph reassigns Medicare benefits to Texas Digestive Disease Consultants, PLLC (Flower Mound, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roy Joseph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Does Roy Joseph hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0963318) is associated with this NPI, valid through July 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Roy Joseph accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Roy Joseph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Roy Joseph affiliated with any hospitals?

According to CMS data, Roy Joseph is affiliated with Medical City Denton.

When was this NPI record last updated?

The NPPES record for Roy Joseph was last updated on November 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.