Individual provider Active NPI

Daniel Roth, MPT, MS ED, CSCS

  • Physical Therapist
  • New York, NY
National Provider Identifier
1497083307
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0287971 Issued in NY
Practice address
424 W 110TH St
Apt 19H
New York, NY 10025-2408
Phone
(917) 774-9997
Fax
(917) 599-0457
NPI assigned
Dec 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0287971 NY Primary

Addresses

Primary practice location

424 W 110TH St
Apt 19H
New York, NY 10025-2408

Mailing address

424 W 110TH St
Apt 19H
New York, NY 10025-2408
Phone (917) 774-9997

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
Master of Science

State licenses

LicenseStateTypeSpecialty
0287971NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maestro Physical Therapy and Rehabilitation, P.C. Physical Therapist Past Accepting new patients
Neal Mesnick, MD, LLC Past Accepting new patients
Tedof3W Physical Therapy Physical Therapist Past Accepting new patients
Infinity Sports Medicine and Rehabilitation, PLLC PastSince May 30, 2009 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1497083307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W 110TH ST",
            "address_2": "APT 19H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252408",
            "telephone_number": "917-774-9997",
            "fax_number": "917-599-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W 110TH ST",
            "address_2": "APT 19H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252408",
            "telephone_number": "917-774-9997",
            "fax_number": "917-599-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MPT, MS ED, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0287971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.