Organization Active NPI

Roth Eye Care PA

  • Optometrist
  • Miami Beach, FL
National Provider Identifier
1356677579
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FL 2436 Issued in FL
Legal business name
ROTH EYE CARE PA
Practice address
1211 17TH St
Miami Beach, FL 33139-2302
Phone
(305) 673-1211
Fax
(305) 532-7684
NPI assigned
Oct 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Authorized official

Name
Dr. David M Roth, O.D.NPI 1922036458
Title
Owner
Phone
(305) 673-1211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X FL 2436 FL Primary

Addresses

Primary practice location

1211 17TH St
Miami Beach, FL 33139-2302

Mailing address

1211 17TH St
Miami Beach, FL 33139-2302
Phone (305) 673-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110803000245 FL Part B Supplier - Clinic/Group Practice 4880863117 Receives reassigned benefits from 2 practitioners
Practice locations: Miami Beach, FL; Miami, FL

National Provider Directory

National Provider Directory

Locations

136 NE 2nd Ave
Miami, FL 33132
Phone (305) 371-2020

1000 17th St
Unit 1C
Miami Beach, FL 33139
Phone (305) 673-1211

1000 17th St
Miami Beach, FL 33139

1674 Alton Rd
Ste 500
Miami Beach, FL 33139
Phone (305) 673-1211

1211 17th St
Miami Beach, FL 33139
Phone (305) 673-1211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1356677579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 17TH ST",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392302",
            "telephone_number": "305-673-1211",
            "fax_number": "305-532-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 17TH ST",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392302",
            "telephone_number": "305-673-1211",
            "fax_number": "305-532-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROTH EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-673-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL 2436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.