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JORDAN ROY
NPI 1972184547
Student in an Organized Health Care Education/Training Program in Staten Island, NY

Active since April 15, 2021PECOS Enrolled
59 SUNSET AVE, STATEN ISLAND, NY 10314(908) 838-3704 Get Directions Write a Review

NPPES record last updated: April 15, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jordan Roy NPPES

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

JORDAN ROY (NPI 1972184547) is an individual student in an organized health care education/training program in Staten Island, New York and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1972184547
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJORDAN ROY
Location Address59 SUNSET AVEStaten Island, NY 10314-5038
Mailing Address59 Sunset AveStaten Island, NY 10314-5038
Phone(908) 838-3704
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateApril 15, 2021
NPPES CertifiedApril 15, 2021
✔ NPI 1972184547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
59 SUNSET AVE, Staten Island, NY 10314
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Roy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921585175
PECOS Enrollment IDI20260120002256
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 Jordan Roy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physician Affiliate Group Of New York PC
18 mi
Dietitian, Registered
506 LENOX AVE
New York, NY 10037
  • Reassigned Medicare billing, New York enrollment
  • 2,094 clinicians in this Medicare group
NPI 1013375526 (212) 939-2467

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

Other Providers at the Same Location NPPES

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

NITA ROY FNP
Medicare Defined Swing Bed Unit
59 SUNSET AVE
STATEN ISLAND, NY 10314
Richmond County (646) 318-9312

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 Jordan Roy's NPI number?

The NPI number for Jordan Roy is 1972184547. It was assigned to this individual provider in the NPPES registry on April 15, 2021.

Where is Jordan Roy located?

Jordan Roy practices at 59 Sunset Ave, Staten Island, NY 10314. The listed phone number is (908) 838-3704.

What is Jordan Roy's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jordan Roy enrolled in Medicare?

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

Which organization bills Medicare for Jordan Roy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Roy reassigns Medicare benefits to Physician Affiliate Group Of New York PC (New York, NY). 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 Jordan Roy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jordan Roy was last updated on April 15, 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.