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JAMES DAVID ROY MD
NPI 1295198216
Surgery in Dothan, AL

Active since March 29, 2016PECOS EnrolledAccepts Medicare Assignment
89.76/100
CMS Quality Rating
4300 W MAIN ST STE 24, DOTHAN, AL 36305(334) 793-1534 Get Directions Write a Review

NPPES record last updated: June 16, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 16, 2021, Mar 29, 2016 (2 updates tracked since 2016).

About James David Roy Md NPPES

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

JAMES DAVID ROY MD (NPI 1295198216) is an individual surgery provider in Dothan, Alabama, licensed in Alabama (36527) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mobile, and is a graduate of University Of Alabama School Of Medicine (2016).

NPPES Registry Identity

NPI1295198216
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJAMES DAVID ROYCredential: MD
Location Address4300 W MAIN ST STE 24Dothan, AL 36305-1312
Mailing Address2451 Fillingim St # St709Mobile, AL 36617-2238 · (251) 471-7990 · Fax (251) 471-7022
Phone(334) 793-1534
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 2016
Enumeration DateMarch 29, 2016
Last NPPES UpdateJune 16, 20212 updates tracked since enumeration
NPPES CertifiedJune 16, 2021
✔ NPI 1295198216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in AL · 36527
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4300 W MAIN ST STE 24, Dothan, AL 36305
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Secondary Practice Location 1

Location 12451 Fillingim St # St709Mobile, AL 36617-2238 · Phone (251) 471-7990 · Fax (251) 471-7022

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James David Roy 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 ID4688961840
PECOS Enrollment IDI20210709001284
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.

Areas of Expertise CMS Part B claims 8

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.

Removal of muscle and/or tissue, each additional 20.0 sq cm or less 11046
This procedure involves the removal of muscle and/or tissue, typically to treat disease or injury. An additional 20.0 square cm or less of tissue may be removed if necessary. The process is performed by a skilled medical professional to ensure your safety and recovery.
120 services13 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
98 services37 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
51 services19 patients
Removal of muscle and/or tissue, 20.0 sq cm or less 11043
This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.
42 services22 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.
25 services16 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
24 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36305 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
Most-billed visit code 99213
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.

89.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.59
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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

Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
2 suppliers11 claims11 services$19.65 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
2 suppliers11 claims11 services$14.25 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers19 claims114 services$2.16 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier12 claims12 services$38.97 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SARA CARROLL KRYSTYN CRNP
Nurse Practitioner
4300 W MAIN ST STE 24
DOTHAN, AL 36305
Houston County (334) 806-6807
SARAH ELIZABETH SLOOP PA-C
Physician Assistant (Surgical)
4300 W MAIN ST STE 24
DOTHAN, AL 36305
Houston County (334) 944-4104

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 James Roy's NPI number?

The NPI number for James Roy is 1295198216. It was assigned to this individual provider in the NPPES registry on March 29, 2016.

Where is James Roy located?

James Roy practices at 4300 W Main St Ste 24, Dothan, AL 36305. The listed phone number is (334) 793-1534.

What is James Roy's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is James Roy enrolled in Medicare?

Yes. James Roy 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.

What insurance does James Roy accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list James Roy 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.

When was this NPI record last updated?

The NPPES record for James Roy was last updated on June 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.