Beth Robins Roth, APRN

Individual provider Active NPI Family Nurse Practitioner · Branford, CT

NPI 1316044845 · NPPES record last updated Dec 9, 2023

Key facts

NPI
1316044845
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
000440 (CT)
Practice address
130 Montowese St Ste 5
Branford, CT 06405-3841
Phone
(203) 824-1249
NPI assigned
Sep 19, 2006
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

130 Montowese St
Suite 5
Branford, CT 06405-3841
Phone (203) 824-1249

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040402000592 CT Practitioner - Nurse Practitioner 4688666167 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
440CTMDHearing Instrument Specialist
000440CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hummingbird Trauma Resolution, LLC Current
since Feb 1, 2017
Accepting new patients
Hannah Isacson D.C. LLC Past
since Sep 18, 2018
Accepting new patients

Locations

635 Foxon Rd
North Branford, CT 06471
Phone (203) 484-5133

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 000440 CT Yes

Addresses

Primary practice location

130 Montowese St Ste 5
Branford, CT 06405-3841

Mailing address

PO Box 185301
Hamden, CT 06518-0301
Phone (203) 824-1249

Other identifiers

IdentifierTypeStateIssuer
008009705MedicaidCT

Other providers in Branford, CT

All providers in Branford, CT · Family Nurse Practitioner in Connecticut

Sources for this page

Verify at the official NPI Registry.