Individual provider Active NPI

Tomer Abraham Roth, MD

  • Diagnostic Radiology Physician
  • La Jolla, CA
National Provider Identifier
1528210416
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
241668-1 Issued in NY
Practice address
10666 N Torey Pines Rd
100C
La Jolla, CA 92037
Phone
(858) 554-2626
NPI assigned
Oct 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 241668-1 NY Primary

Addresses

Primary practice location

10666 N Torey Pines Rd
100C
La Jolla, CA 92037

Mailing address

10790 Rancho Bernardo Rd # 4S-205
San Diego, CA 92127-5705
Phone (858) 605-7171

Other identifiers 1

IdentifierTypeStateIssuer
0A1126780MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251022003040 FL Practitioner - Diagnostic Radiology 6608907761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intellirad Imaging LLCGroup PAC ID 9739333790, 60 clinicians

Practice addresses (Care Compare)

3663 S Miami Ave
Miami, FL 33133-4253
Phone (305) 854-4400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241668-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intellirad Imaging, LLC Diagnostic Radiology CurrentSince Nov 1, 2025 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Clinic Medical Group PastSince May 17, 2020 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

3663 S Miami Ave
Miami, FL 33133
Phone (305) 285-2131

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: troth356886@scrippshlth.medalliesdirect.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 5

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": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1528210416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD # 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10666 N TOREY PINES RD",
            "address_2": "100C",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-554-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "TOMER",
        "middle_name": "ABRAHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "241668-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A1126780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.