Daniel Jay Roth, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

81112 Issued in CT

Practice address

1665 Ellington Rd
South Windsor, CT 06074-2778

Phone

(860) 648-2447

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, PA, CT3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: droth537798@ehrdirect.uhhospitals.org

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Pediatrics

  Medicare reassignment NPD
• Columbus Ambulatory Healthcare Services, Inc.

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1790733244

  Pediatrics

  Medicare reassignment NPD
• MPPG, Inc.

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1033131172

  Pediatrics

  Medicare reassignment NPD
• Reading Hospital

  • Radiation Oncology Physician
  • West Reading, PA
  • NPI 1992387518
  Medicare reassignment NPD
• Columbus Ambulatory Healthcare Services, Inc.

  • Family Medicine Physician
  • Phenix City, AL
  • NPI 1699240531
  NPD
• Reading Hospital

  • Infectious Disease Physician
  • West Reading, PA
  • NPI 1194162537
  NPD
• Reading Hospital

  • Community/Retail Pharmacy
  • Limerick, PA
  • NPI 1487468914
  NPD
• South Windsor Pediatrics, LLC

  • Pediatric Adolescent Medicine Physician
  • South Windsor, CT
  • NPI 1851588701
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1467541078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 D YOUVILLE LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742778",
            "telephone_number": "860-648-2447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 D Youville Ln",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303411460",
            "country_code": "US",
            "telephone_number": "267-980-3116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "DANIEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "81112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Rodriguez
• Kimberly Rogoz
• Pietro Rondinelli, P.A.-C
• Ellen Carol Ronsivalli, RD
• Room to Grow Counseling
• Lani Dove Roth, LMT
• Stacey Roy
• Rubin Dental Practice
• Rubin Family Dentistry & Associates, LLC
• Mark D. Rubin, D.M.D.

• Pediatric Adolescent Medicine Physician in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Pediatric Adolescent Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.