Individual provider Active NPI

Harold Franklin Roth, D.O.

  • General Practice Physician
  • Lansing, MI
National Provider Identifier
1023005659
Registry record updated Jan 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5101007838 Issued in MI
Practice address
1627 Lake Lansing Rd
Suite 200
Lansing, MI 48912-3788
Phone
(517) 485-1789
Fax
(517) 485-2357
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101007838 MI Primary

Addresses

Primary practice location

1627 Lake Lansing Rd
Suite 200
Lansing, MI 48912-3788

Mailing address

1627 Lake Lansing Rd
Suite 200
Lansing, MI 48912-3788
Phone (517) 485-1789

Other identifiers 5

IdentifierTypeStateIssuer
112117791MedicaidMI
200000005857OtherMIPHP OF MID-MICHIGAN
38-2402492OtherFEDERAL EMPLOYER ID NUMBE
0153310524OtherMIBCBSM
201488OtherMIMCLAREN HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505000591 MI Practitioner - General Practice 6204964695 Receives reassigned benefits from 1 practitioner
Practice locations: Dewitt, MI; East Lansing, MI; Grand Ledge, MI; Holt, MI; Lansing, MI

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Michigan State University College of Osteopathic Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11656 Hartel Rd
Grand Ledge, MI 48837-8148
Phone (517) 622-1009

16260 Park Lake Rd
East Lansing, MI 48823-9480
Phone (517) 339-2322

1627 Lake Lansing Rd
Suite 200
Lansing, MI 48912-3788
Phone (517) 485-1789

3255 Coleman Rd
East Lansing, MI 48823-7330
Phone (517) 324-1999

7099 State Rd
East Lansing, MI 48823-9440
Phone (517) 339-2179

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Suncare Home Health Home health agency, Shelby Township, MI, CCN 239191
  • Corsocare Hospice Hospice, Milford, MI, CCN 231649
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101007838MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary E Barna DPM & Associates PC Past Accepting new patients
Avalon Consultants PLLC Family Medicine Past Accepting new patients
Harold F. Roth, D.O. General Practice PastSince Jan 6, 1981 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: harold.roth.1@31091.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCJEDD/Endpoint/DCJEDD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514764800000",
    "number": "1023005659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 LAKE LANSING RD",
            "address_2": "SUITE 200",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123788",
            "telephone_number": "517-485-1789",
            "fax_number": "517-485-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 LAKE LANSING RD",
            "address_2": "SUITE 200",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123788",
            "telephone_number": "517-485-1789",
            "fax_number": "517-485-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "HAROLD",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2018-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101007838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112117791",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP OF MID-MICHIGAN",
            "identifier": "200000005857",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL EMPLOYER ID NUMBE",
            "identifier": "38-2402492",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0153310524",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "201488",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.