Individual provider Active NPI

Diana Roth, MD

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1477559086
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
225761-1 Issued in NY
Practice address
5925 15TH Ave
Brooklyn, NY 11219-5009
Phone
(718) 972-2700
Fax
(718) 532-1724
NPI assigned
Jun 28, 2005
Reactivated
Mar 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 225761-1 NY Primary

Addresses

Primary practice location

5925 15TH Ave
Brooklyn, NY 11219-5009

Mailing address

5925 15TH Ave
Brooklyn, NY 11219-5009
Phone (718) 972-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051017000466 NY Practitioner - Obstetrics/Gynecology 7810913134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boro Park Obstetrics and Gynecology P.C.Group PAC ID 4789743576, 17 clinicians

Practice addresses (Care Compare)

5925 15TH Ave
Brooklyn, NY 11219-5009
Phone 71897227001121

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
89.92
Improvement activities
40
Cost
77.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225761-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
MMC OB/GYN Hospital Specialist Past Accepting new patients
Womencare Obstetrics and Gynecology P.C. PastSince Sep 22, 1992 Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: dianaroth@mai.allscriptsdirect.net

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 1

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1477559086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 15TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195009",
            "telephone_number": "718-972-2700",
            "fax_number": "718-532-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 15TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195009",
            "telephone_number": "718-972-2700",
            "fax_number": "718-532-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2018-03-30",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "225761-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.