Jeffrey Ira Roth, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

041654 Issued in GA

Practice address

4385 Johns Creek Pkwy
Ste 250
Suwanee, GA 30024-6048

Phone

(770) 623-1608

Fax

(678) 992-2540

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Otolaryngology

Education

State University of Ny Upstate Medical University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Atlanta Ear Nose and Throat, P.C.Group PAC ID 7012979636, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jroth2778@choa.gadirect.net

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.

• Northeast Atlanta Ear Nose & Throat, PC

  • Otolaryngology Physician
  • Suwanee, GA
  • NPI 1194836254
  Medicare reassignment Care Compare group NPD
• Northlake Anesthesia Professionals, LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1982637419
  NPD (past)

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

• Ehca Johns Creek, LLC

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1417945320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 JOHNS CREEK PKWY",
            "address_2": "STE 250",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246048",
            "telephone_number": "770-623-1608",
            "fax_number": "678-992-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4385 JOHNS CREEK PKWY",
            "address_2": "STE 250",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246048",
            "telephone_number": "770-623-1608",
            "fax_number": "678-992-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JEFFREY",
        "middle_name": "IRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "041654",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "GA",
            "license": "041654",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "GA",
            "license": "041654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000714381M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000714381J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley S Rosales Mejia, PAC
• Cameron Rosato, RBT
• Jay L Rosenheck, D.D.S.
• Jacquelyn Alexandra Ross, OTR/L
• Melanie Ross, LAPC
• Kara Rothmann, PSY.D.
• Jennifer W. Rotunda, LPC, LMHC, NCC
• Isis Joi Rouse
• Chanel Rouzaud, RBT
• RS Novatus Physical Therapy LLC

• Otolaryngology Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.