Jacob B. Roth, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1194 Issued in MD

Practice address

2110 Priest Bridge Dr
Suite 4
Crofton, MD 21114-2472

Phone

(301) 858-9880

Fax

(410) 721-2895

NPI assigned

Jun 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1977

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• J.B. Roth and Assoc. P.a.

  • Psychologist
  • Crofton, MD
  • NPI 1801838214
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1326080730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 PRIEST BRIDGE DR",
            "address_2": "SUITE 4",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142472",
            "telephone_number": "301-858-9880",
            "fax_number": "410-721-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 PRIEST BRIDGE DR",
            "address_2": "SUITE 4",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142472",
            "telephone_number": "301-858-9880",
            "fax_number": "410-721-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JACOB",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "1194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Marie Rodgers, CRNP
• Glynnis Rodgers
• Salena Rosa, COSMETOLOGIST
• Nancy Theresa Rose, R.N.
• Kimberly Nielsen Rosenbaum
• Nancy Fox Royster, RN
• Tashauna Nicole Royster, RBT
• Sarah J Russ, L.M.S.W.
• Sabena Home Health Services LLC
• Sacred Medicine LLC

• Psychologist in Crofton, MD
• Providers in Crofton, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.