Marlene Margaret Roth, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301067678 Issued in MI

Practice address

31815 Southfield Rd
Suite 14
Beverly Hills, MI 48025-5471

Phone

(248) 644-2700

Fax

(248) 644-4783

NPI assigned

Jul 10, 2008

Last updated

Mar 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: drmarlene@villagepediatrics.opdirect.net
• Direct secure messaging: mroth1149636@direct.hfhs.org

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

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)
• Village Pediatrics PLLC

  • Pediatric Adolescent Medicine Physician
  • Beverly Hills, MI
  • NPI 1962780767
  NPD (past)

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1053574954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD STE 10",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-644-2700",
            "fax_number": "248-644-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD",
            "address_2": "SUITE 14",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-644-2700",
            "fax_number": "248-644-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARLENE",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301067678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ramaj
• Mark E Redman, MD
• Jumoi-Antonio Shemar-David Reid, LPC, LLMFT, MA, NCC
• Bailey Rice, RDN
• Samantha Robbins, MS, CCC-SLP
• Jaber Saad, MD
• Joseph Salama, M.D.
• Sales,Food,&Health Service LLC
• Kelly L Salter, AT
• Rakel K Sami, NP

• Pediatrics Physician in Beverly Hills, MI
• Providers in Beverly Hills, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.