Individual provider Active NPI

Karen S. Roth, ANP-BC, ACHPN

  • Adult Health Nurse Practitioner
  • Newark, NY
National Provider Identifier
1093714784
Registry record updated Mar 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F300625 Issued in NY
Practice address
1208 Driving Park Ave
Newark, NY 14513-1057
Phone
(315) 359-2640
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F300625 NY Primary

Addresses

Primary practice location

1208 Driving Park Ave
Newark, NY 14513-1057

Mailing address

4195 W Walworth Rd
Macedon, NY 14502-9313
Phone (315) 986-5771

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000787 NY Practitioner - Nurse Practitioner 3971543687 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
300625NYMDLicensed Practical Nurse
F300625NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Springs Sanitarium Co CurrentSince Oct 1, 2016 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Oct 1, 2016 Accepting new patients
Rochester General Hospital CurrentSince Oct 1, 2008 Accepting new patients
Rochester General Hospital Current Accepting new patients
Rochester General Hospital Adult Health CurrentSince Oct 1, 2008 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1208 Driving Park Ave
Newark, NY 14513
Phone (315) 359-2640

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
#242
Rochester, NY 14621
Phone (585) 922-3662

Interoperability endpoints

  • Direct secure messaging: kroth33957@direct.rochesterregional.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1093714784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4195 W WALWORTH RD",
            "city": "MACEDON",
            "state": "NY",
            "postal_code": "145029313",
            "telephone_number": "315-986-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 DRIVING PARK AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131057",
            "telephone_number": "315-359-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KAREN",
        "middle_name": "S.",
        "credential": "ANP-BC, ACHPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F300625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

Verify at the official NPI Registry.