Individual provider Active NPI

Roger W Werth, MD

  • Surgery Physician
  • Aberdeen, SD
National Provider Identifier
1245216118
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1908 Issued in SD
Practice address
310 S Penn St
Aberdeen, SD 57401-4553
Phone
(605) 229-1367
Fax
(605) 229-1002
NPI assigned
Dec 21, 2005
Last updated
Dec 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1908 SD Primary

Addresses

Primary practice location

310 S Penn St
Aberdeen, SD 57401-4553

Mailing address

310 S Penn St
Aberdeen, SD 57401-4553
Phone (605) 229-1367

Other identifiers 1

IdentifierTypeStateIssuer
7300992MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20041022000645 SD Practitioner - General Surgery 9537141767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1908SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St. Luke's Current Accepting new patients
Avera St. Lukes CurrentSince Aug 1, 2014 Accepting new patients
Avera St. Luke's CurrentSince Aug 1, 2014 Accepting new patients

Locations

201 S Lloyd St
Ste E202
Aberdeen, SD 57401
Phone (605) 622-2605

310 S Pennsylvania St
Aberdeen, SD 57401
Phone (605) 229-1367

310 S Pennsylvania St
Ste 201
Aberdeen, SD 57401
Phone (605) 229-1367

Organizations & group practices 3

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1245216118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S PENN ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014553",
            "telephone_number": "605-229-1367",
            "fax_number": "605-229-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S PENN ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014553",
            "telephone_number": "605-229-1367",
            "fax_number": "605-229-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTH",
        "first_name": "ROGER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "1908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7300992",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.