Individual provider Active NPI

Maxwell Taylor Roth, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Boston, MA
National Provider Identifier
1609452168
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
1021580 Issued in MA
Practice address
330 Brookline Ave
Beth Israel Deaconess Medical Center Dept of Pathology
Boston, MA 02215-5400
Phone
(617) 667-7000
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 1021580 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Beth Israel Deaconess Medical Center Dept of Pathology
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Beth Israel Deaconess Medical Center Dept of Pathology
Boston, MA 02215-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260602000708 MA Practitioner - Pathology 8426465725

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Albert Einstein College of Medicine of Yeshiva University, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400

330 Brookline Ave
Boston, MA 02215-5491

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1609452168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF PATHOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF PATHOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MAXWELL",
        "middle_name": "TAYLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "1021580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.