Individual provider Active NPI

Kevin Roth, DO

  • Emergency Medicine Physician
  • Allentown, PA
National Provider Identifier
1386672350
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS009858L Issued in PA
Practice address
1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone
(610) 402-8111
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS009858L PA Primary

Addresses

Primary practice location

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

Mailing address

PO Box 1754
Allentown, PA 18105-1754

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101102000267 PA Practitioner - Emergency Medicine 6103010301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

I-78 Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 402-5369

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS009858LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Aug 31, 2000 Accepting new patients
Lehigh Valley Physician Group Emergency Medicine Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 31, 2000 Accepting new patients

Locations

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2545 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 884-2888

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386672350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1754",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036202",
            "telephone_number": "610-402-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KEVIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS009858L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.