Richard E Roth, DO
Individual provider Active NPI Ophthalmology Physician · Kingston, PA
NPI 1366449977 · NPPES record last updated May 15, 2026
Key facts
- NPI
- 1366449977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- OS011086 (PA)
- Practice address
- 703 Rutter Ave
Kingston, PA 18704-4801 - Phone
- (570) 288-7405
- Fax
- (570) 288-7406
- NPI assigned
- Jun 29, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Ophthalmology
- Education
- Philadelphia College of Osteopathic Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vision Innovation Centers of Pennsylvania LLC
Practice addresses (Care Compare)
703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.08 of 100
- Quality
- 85.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 64.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 779 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031112000374 | PA | Practitioner - Ophthalmology | 8426961632 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS011086 | PA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Innovation Centers of Pennsylvania, LLC | Ophthalmology | Current |
Accepting new patients |
| Vision Innovation Centers of Pennsylvania LLC | Ophthalmology | Current | Accepting new patients |
| Vision Innovation Centers of Pennsylvania LLC | Current |
Accepting new patients | |
| Roth & Russin LLC | Past | Accepting new patients | |
| Vision Innovation Centers of Pennsylvania LLC | Ophthalmology | Past | Accepting new patients |
| The New York Eye & Ear Infirmary Ophthalmology Associates, P.C. | Past | Accepting new patients | |
| Laser and Microsurgery, PC | Ophthalmology | Past |
Accepting new patients |
Locations
2661 Riva Rd
Ste 1030
Annapolis, MD 21401
789 Airport Rd
Ste 105
Hazle Township, PA 18202
Phone (570) 455-3391
703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405
4100 Linglestown Rd
Linglestown, PA 17112
Phone (717) 657-2020
174 Harvest Ln
Pocono Summit, PA 18346
Phone (272) 639-5430
170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010
Interoperability endpoints
- rroth@vip.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | OS011086 | PA | Yes |
Addresses
Primary practice location
703 Rutter Ave
Kingston, PA 18704-4801
Mailing address
2661 Riva Rd Ste 1030
Annapolis, MD 21401-7131
Phone (570) 288-7405
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001968181 | Medicaid | PA |
Other providers in Kingston, PA
- Leonard F Romanowski
- Heather Tiffany Rosa I
- John W Rosencrans
- Hillary Rosendale
- Andrea Ross
- Diana Ruhf
- Jennifer Runquist
- John Wesley Rusen
- Patricia Russo
- Bruce H Saidman
All providers in Kingston, PA · Ophthalmology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.