Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ROY JARETH LACKEY PA-C
NPI 1962169011
Physician Assistant in Fpo, AE

Active since November 23, 2021PECOS Enrolled

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Aug 24, 2026, Feb 22, 2023, Nov 23, 2021 (3 updates tracked since 2021).

About Roy Jareth Lackey Pa-c NPPES

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

ROY JARETH LACKEY PA-C (NPI 1962169011) is an individual physician assistant in Fpo, AE, licensed in California (PA62549) and active in the NPI registry since November 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962169011
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameROY JARETH LACKEYCredential: PA-C
Location AddressPSC 819 BOX 18Fpo, AE 09645-0001
Mailing Address32863 Abana CtTemecula, CA 92592-9271 · (843) 597-5477
Sole ProprietorNo
Enumeration DateNovember 23, 2021
Last NPPES UpdateAugust 24, 20263 updates tracked since enumeration
NPPES CertifiedAugust 24, 2026
✔ NPI 1962169011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA62549
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roy Jareth Lackey Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

Family Medicine
PSC 819 BOX 18
FPO, AE 09645
Pharmacist
PSC 819 BOX 18
FPO, AE 09645
Pediatrics
PSC 819 BOX 18
FPO, AE 09645
Pharmacist
PSC 819 BOX 18
FPO, AE 09645
Dentist
PSC 819 BOX 18
FPO, AE 09645
Dietitian, Registered
PSC 819 BOX 18
FPO, AE 09645
Dentist (Prosthodontics)
PSC 819 BOX 18
FPO, AE 09645
Physician Assistant
PSC 819 BOX 18
FPO, AE 09645

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 Lackey's NPI number?

The NPI number for Roy Lackey is 1962169011. It was assigned to this individual provider in the NPPES registry on November 23, 2021.

Where is Roy Lackey located?

Roy Lackey practices at Psc 819 Box 18, Fpo, AE 09645. The listed phone number is (314) 727-3606.

What is Roy Lackey's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Roy Lackey enrolled in Medicare?

Yes. Roy Lackey is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Roy Lackey was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.