Individual provider Active NPI

Gerald B. Roth, DO

  • Family Medicine Physician
  • Tucson, AZ
National Provider Identifier
1255490322
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2224 Issued in AZ
Practice address
6236 E Pima St Ste 100
Tucson, AZ 85712-3164
Phone
(520) 327-6874
Fax
(520) 327-0028
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2224 AZ Primary

Addresses

Primary practice location

6236 E Pima St Ste 100
Tucson, AZ 85712-3164

Mailing address

5055 E Broadway Blvd Ste A100
Tucson, AZ 85711-3629
Phone (520) 327-0460

Other practice location 1

7885 N Oracle Rd
Tucson, AZ 85704-6348
Phone (520) 202-1585

Other practice location 2

100 E Ajo Way
Tucson, AZ 85713-6105
Phone (520) 889-8879

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gerald.roth.1@1576.direct.athenahealth.com
Direct Messaging Address gerald.roth@nwhc.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20120323000231 AZ Practitioner - Family Practice 9032379326 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2224AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physician PC CurrentSince Nov 1, 2021 Accepting new patients
Arizona Community Physicians PC Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Northwest Allied Physicians, LLC CurrentSince Aug 5, 2013 Accepting new patients
Northwest Allied Physicians LLC CurrentSince Aug 5, 2013 Accepting new patients

Locations

7885 N Oracle Rd
Tucson, AZ 85704
Phone (520) 232-5280

6236 E Pima St
Ste 100
Tucson, AZ 85712
Phone (520) 327-6874

6236 E Pima St
Tucson, AZ 85712
Phone (520) 327-6874

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

Interoperability endpoints

  • Direct secure messaging: gerald.roth.1@1576.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1255490322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 E BROADWAY BLVD STE A100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113629",
            "telephone_number": "520-327-0460",
            "fax_number": "520-795-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6236 E PIMA ST STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123164",
            "telephone_number": "520-327-6874",
            "fax_number": "520-327-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7885 N Oracle Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857046348",
            "country_code": "US",
            "telephone_number": "520-202-1585",
            "fax_number": "520-202-1590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Ajo Way",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136105",
            "country_code": "US",
            "telephone_number": "520-889-8879",
            "fax_number": "520-294-2911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "GERALD",
        "middle_name": "B.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gerald.roth.1@1576.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "7885 N Oracle Rd",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857046348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gerald.roth@nwhc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "7885 N Oracle Rd",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857046348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.