Jeremy Bonn Roth, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

D50052 Issued in MD

Practice address

7490 New Technology Way
Frederick, MD 21703-8370

Phone

(240) 566-1600

NPI assigned

Jun 2, 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Anesthesiology

Education

Rush Medical College of Rush University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia and Analgesia Medical Group IncGroup PAC ID 1153316112, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• Providence Queen of the Valley Medical Center Hospital, Napa, CA, CCN 050009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Anesthesia & Analgesia Medical Group, Inc.

  • Anesthesiology Physician
  • Santa Rosa, CA
  • NPI 1659320984
  Medicare reassignment Care Compare group NPD
• Lifebridge Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Randallstown, MD
  • NPI 1003992868
  NPD (past)
• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Norcal Healthconnect LLC

  dba Petaluma Valley Hospital

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Queen of the Valley Medical Center

  • General Acute Care Hospital
  • Napa, CA
  • NPI 1013080084
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Queen of the Valley Medical Center

  • General Acute Care Hospital
  • Napa, CA
  • NPI 1235218785
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1346288628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 HILLSTEAD DR",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7490 NEW TECHNOLOGY WAY",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038370",
            "telephone_number": "240-566-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JEREMY",
        "middle_name": "BONN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D50052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FECA",
            "identifier": "601285800",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834910000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Christopher Rosko, PA-C
• Deborah L Rosman, OTR L
• Michelle Doris Ross, LMSW
• Rozalyn Ross
• Samantha Ross, LGPC
• Trudy Roth, PT
• Stephanie Michell Rothenberger
• Raymond Richard Rother, PH.D., LCSW-C
• Michelle Rouch
• Mackenzie Rourke, NCC, LPC

• Anesthesiology Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.