Individual provider Active NPI

Matthew Jacob Roth, LAC

  • Acupuncturist
  • Bronx, NY
National Provider Identifier
1205745635
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
007969 Issued in NY
Practice address
2510 Westchester Ave Ste 110
Bronx, NY 10461-3585
Phone
(929) 303-1666
NPI assigned
Sep 2, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 007969 NY Primary

Addresses

Primary practice location

2510 Westchester Ave Ste 110
Bronx, NY 10461-3585

Mailing address

133 Lincoln Ave Apt 3
Bronx, NY 10454-4432
Phone (929) 303-1666

Other practice location 1

61 Irving Pl
New York, NY 10003-2324
Phone (929) 303-1666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1205745635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 LINCOLN AVE APT 3",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544432",
            "telephone_number": "929-303-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 WESTCHESTER AVE STE 110",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613585",
            "telephone_number": "929-303-1666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Irving Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100032324",
            "country_code": "US",
            "telephone_number": "929-303-1666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MATTHEW",
        "middle_name": "JACOB",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "007969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.