Active NPI
Scott L Roth, MD
- Allergy Physician
- Rochester, NY
National Provider Identifier
1033113543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 150-586
- Practice address
- 1012 Elmgrove Rd
Rochester, NY 14624-1324 - Phone
- (585) 426-4160
- Fax
- (585) 426-4167
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | 150-586 | NY | Primary |
Addresses
Primary practice location
1012 Elmgrove Rd
Rochester, NY 14624-1324
Mailing address
1012 Elm Grove Rd
Rochester, NY 14625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01449238 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150-586 | NY | MD | Allergy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033113543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 ELM GROVE RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 ELMGROVE RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146241324",
"telephone_number": "585-426-4160",
"fax_number": "585-426-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "SCOTT",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "NY",
"license": "150-586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01449238",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.