MEDICARE: NIKITA ROY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	C201006	CA
2	208000000X	Pediatrics Physician	313713	NY
3	208000000X	Pediatrics Physician	MD467730	PA

General Provider Information

NPI Number	:	1558723759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKITA ROY MD

Provider Business Mailing Address
First Line	:	1141 PEAR TREE LN
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94558-6484
Country	:	US
Telephone Number	:	707-254-1170
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 CHADBOURNE RD STE A
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-9620
Country	:	US
Telephone Number	:	707-419-8989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2016
Last Update Date	:	02/19/2026

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Directions to “ NIKITA ROY MD” Practice Location

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