Katherine G Roth, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

207319 Issued in NY

Practice address

12 Medical Dr
Ste D
Port Jefferson Station, NY 11776-1588

Phone

(631) 928-1222

Fax

(631) 928-8605

NPI assigned

Nov 7, 2005

Sex

Female

Sole proprietor

Yes

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 NY

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

Specialty

Neurology

Education

George Washington University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
• St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
• St Charles Hospital Inpatient rehabilitation facility, Port Jefferson, NY, CCN 33T246

Merit-based Incentive Payment System (MIPS)

Final score

29.39 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

97.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation
• St Charles Hospital Corp

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  Care Compare affiliation
• St Charles Hospital Corp

  • Rehabilitation Hospital Unit
  • Port Jefferson, NY
  • NPI 1225097652

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1083695233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MEDICAL DR",
            "address_2": "STE D",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761588",
            "telephone_number": "631-928-1222",
            "fax_number": "631-928-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MEDICAL DR",
            "address_2": "STE D",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761588",
            "telephone_number": "631-928-1222",
            "fax_number": "631-928-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KATHERINE",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "207319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan E Roitman, DDS
• Robert Allen Rook, DC
• Anthony Rosalia
• Kenneth G Rosenthal, MD
• Joey Rossi
• Talissa Rozzell-Mercado
• Rrjslp, Inc
• Gina Marie Rubino
• Donna Ruddy
• Peyton R Rufo

• Neurology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.