NPIMap

Individual provider Active NPI

Leslie Aileen Roth, M.D.

  • Colon & Rectal Surgery Physician
  • Providence, RI
National Provider Identifier
1386764785
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD12703 Issued in RI
Practice address
208 Collyer St
Suite 302
Providence, RI 02904-1560
Phone
(401) 553-8312
Fax
(401) 868-2306
NPI assigned
Mar 30, 2007
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD429123 PA
Colon & Rectal Surgery Physician 208C00000X MD12703 RI Primary

Addresses

Primary practice location

208 Collyer St
Suite 302
Providence, RI 02904-1560

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address leslie.roth@usasurg.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081107000369 RI Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 9739248584 Reassigns benefits to 2 organizations
I20181219001723 MA Practitioner - Colorectal Surgery (Proctology) 9739248584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Practice addresses (Care Compare)

1454 S County TRL
East Greenwich, RI 02818-1749
Phone (401) 793-5700

195 Collyer St
Suite 302
Providence, RI 02904-1869
Phone (401) 793-5140

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD429123PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
Lifespan Physician Group of Massachusetts Inc Surgery CurrentSince Jan 19, 2026 Accepting new patients
Lifespan Physician Group, Inc. Surgery CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

562 Washington St
South Attleboro, MA 02703
Phone (401) 725-4888

738 Washington St
South Attleboro, MA 02703
Phone (508) 761-6025

1407 S County Trl
Ste 423
East Greenwich, RI 02818
Phone (401) 228-0590

1454 S County Trl
East Greenwich, RI 02818
Phone (401) 606-1100

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

146 W River St
Ste 11C
Providence, RI 02904
Phone (401) 606-3000

195 Collyer St
Ste 302
Providence, RI 02904
Phone (401) 793-5140

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

208 Collyer St
Ste 301A
Providence, RI 02904
Phone (401) 725-4888

Interoperability endpoints

  • Direct secure messaging: lroth13761@brownhealth.medalliesdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1386764785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLLYER ST",
            "address_2": "SUITE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041560",
            "telephone_number": "401-553-8312",
            "fax_number": "401-868-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "LESLIE",
        "middle_name": "AILEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD429123",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "RI",
            "license": "MD12703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leslie.roth@usasurg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "208 Collyer St",
            "address_2": "Suite 302",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029041560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.