Active NPI
Martin R. Roth, PH.D.
- Psychologist
- White Plains, NY
National Provider Identifier
1174747125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 7409
- Practice address
- 19 Dupont Ave
White Plains, NY 10605-3537 - Phone
- (914) 949-3050
- NPI assigned
- Apr 12, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 7409 | NY | Primary |
Addresses
Primary practice location
19 Dupont Ave
White Plains, NY 10605-3537
Mailing address
19 Dupont Ave
White Plains, NY 10605-3537
Phone (914) 949-3050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477872000000",
"number": "1174747125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 DUPONT AVE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106053537",
"telephone_number": "914-949-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 DUPONT AVE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106053537",
"telephone_number": "914-949-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "MARTIN",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2016-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "7409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.