Active NPI
Mark D Roth, MD
- Surgery Physician
- Waynesboro, PA
National Provider Identifier
1144210279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD060014L
- Practice address
- 45 Roadside Ave
Waynesboro, PA 17268-2542 - Phone
- (717) 762-7155
- Fax
- (717) 762-6929
- NPI assigned
- Oct 28, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD060014L | PA | Primary |
Addresses
Primary practice location
45 Roadside Ave
Waynesboro, PA 17268-2542
Mailing address
785 5TH Avenue
Suite 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555
Other identifiers 28
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25-1716306 | Other | PA | MULTIPLAN/PHCS |
| 546216-01 | Other | MD | MD BLUE SHIELD |
| 367632 | Other | PA | MAMSI |
| 6720367 | Other | PA | AETNA HMO |
| 867633 | Other | PA | MEDICARE GROUP # |
| P00700657 | Other | PA | RAILROAD MEDICARE |
| 02195701 | Other | PA | CAPITAL BLUE CROSS |
| 25-1716306 | Other | PA | INFORMED |
| 25-1716306 | Other | PA | DEVON |
| 25-1716306 | Other | PA | HEALTHNET/TRICARE |
| 990003822 | Other | PA | MEDICARE RAILROAD RETIRE |
| 1007307260034 | Other | PA | MEDICAID GROUP # |
| 25-1716306 | Other | PA | GREATWEST HEALTHCARE |
| 5234477 | Other | PA | AETNA HMO |
| 25-1716306 | Other | PA | SOUTH CENTRAL PREFERRED |
| 257729 | Other | PA | UNISON |
| 908528 | Other | PA | HIGHMARK BLUESHIELD |
| G920-0109/233CCU | Other | PA | CAREFIRST |
| MD060014L | Other | PA | LICENSE |
| 0016462400002 | Medicaid | PA | |
| 1561881 | Other | PA | GATEWAY |
| 120420403 | Other | PA | DEPT OF LABOR |
| 25-1716306 | Other | PA | FIRST HEALTH |
| 267632 | Other | MD | MAMSI OP CHOICE |
| 25-1716306 | Other | PA | HEALTH AMERICA |
| 25-1716306 | Other | PA | INTERGROUP |
| 5234477 | Other | PA | AETNA NON-HMO |
| 810688 | Other | PA | AETNA PPO |
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 |
|---|---|---|---|
| MD060014L | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group Inc. | Surgery | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
2425 Garden Way
Ste 101
Hermitage, PA 16148
Phone (724) 347-0870
740 E State St
Sharon, PA 16146
Phone (724) 983-1980
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1144210279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "785 5TH AVENUE",
"address_2": "SUITE 3",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172014232",
"telephone_number": "717-263-9555",
"fax_number": "717-217-4217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 ROADSIDE AVE",
"city": "WAYNESBORO",
"state": "PA",
"postal_code": "172682542",
"telephone_number": "717-762-7155",
"fax_number": "717-762-6929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "MARK",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-28",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD060014L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN/PHCS",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD BLUE SHIELD",
"identifier": "546216-01",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "367632",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "6720367",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "867633",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00700657",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "02195701",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INFORMED",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVON",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET/TRICARE",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD RETIRE",
"identifier": "990003822",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP #",
"identifier": "1007307260034",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST HEALTHCARE",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "5234477",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH CENTRAL PREFERRED",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "257729",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUESHIELD",
"identifier": "908528",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "G920-0109/233CCU",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "MD060014L",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016462400002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1561881",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "120420403",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI OP CHOICE",
"identifier": "267632",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERGROUP",
"identifier": "25-1716306",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON-HMO",
"identifier": "5234477",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "810688",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waynesboro, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.