Active NPI
Andrew Michael Roth, MD
- Dermatology Physician
- Tucson, AZ
National Provider Identifier
1376246538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- R80690
- Practice address
- 7165 N Pima Canyon Dr
Tucson, AZ 85718-1407 - Phone
- (312) 766-4949
- Fax
- (312) 766-4925
- NPI assigned
- Mar 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | R80690 | AZ | Primary |
Addresses
Primary practice location
7165 N Pima Canyon Dr
Tucson, AZ 85718-1407
Mailing address
7165 N Pima Canyon Dr
Tucson, AZ 85718-1407
Phone (520) 694-8888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R80690 | AZ | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1376246538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7165 N PIMA CANYON DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857181407",
"telephone_number": "520-694-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7165 N PIMA CANYON DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857181407",
"telephone_number": "312-766-4949",
"fax_number": "312-766-4925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "ANDREW",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-24",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "AZ",
"license": "R80690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.