Active NPI
Monique E Roth, MD
- Dermatology Physician
- Dedham, MA
National Provider Identifier
1427055953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 75907
- Practice address
- 1 Lyons St
Dedham, MA 02026-5599 - Phone
- (781) 329-1400
- Fax
- (781) 278-5667
- NPI assigned
- Jun 30, 2005
- Sex
- Female
- 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 | 75907 | MA | Primary |
Addresses
Primary practice location
1 Lyons St
Dedham, MA 02026-5599
Mailing address
PO Box 9120
Dedham, MA 02027-9120
Phone (781) 329-1400
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0300320 | Other | UNITED HEALTHCARE(HMO/PPO | |
| 075907 | Other | TUFTS | |
| 2733572 | Other | MA | HEALTHSOURCE |
| 0014523 | Other | NEIGHBORHOOD HEALTH PLAN | |
| 401095 | Other | HARVARD PILGRIM PPO | |
| 070013072 | Other | RAILROAD MEDICARE | |
| 2733572 | Other | CIGNA HEALTH CARE | |
| 27684 | Other | CHILDREN'S MED. SECURITY | |
| 3193B70 | Other | MASS.HEALTH(DIV.MEDSVCS) | |
| 401095 | Other | HARVARD PILGRIM | |
| 401095 | Other | HARVARD PILGRIM POS | |
| J16188 | Other | BLUE SHIELD INDEMNITY | |
| J16188 | Other | BS-BLUE CARE ELECT | |
| 075907 | Other | TUFTS BENEFIT ADMIN. | |
| 075907 | Other | TUFTS COMMONWEALTH PPO | |
| 075907 | Other | TUFTS TOTAL HEALTH PLAN | |
| G17464 | Other | FIRST SENIORITY | |
| J16188 | Other | HMO BLUE/BLUE CHOICE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1427055953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9120",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020279120",
"telephone_number": "781-329-1400",
"fax_number": "781-278-5667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LYONS ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020265599",
"telephone_number": "781-329-1400",
"fax_number": "781-278-5667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "MONIQUE",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-30",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "75907",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE(HMO/PPO",
"identifier": "0300320",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "075907",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "2733572",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0014523",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM PPO",
"identifier": "401095",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "070013072",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH CARE",
"identifier": "2733572",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILDREN'S MED. SECURITY",
"identifier": "27684",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS.HEALTH(DIV.MEDSVCS)",
"identifier": "3193B70",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "401095",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM POS",
"identifier": "401095",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "J16188",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS-BLUE CARE ELECT",
"identifier": "J16188",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS BENEFIT ADMIN.",
"identifier": "075907",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS COMMONWEALTH PPO",
"identifier": "075907",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS TOTAL HEALTH PLAN",
"identifier": "075907",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST SENIORITY",
"identifier": "G17464",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO BLUE/BLUE CHOICE",
"identifier": "J16188",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dedham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.