Individual provider Active NPI

Robert Howard Roth, MD

  • Orthopaedic Hand Surgery Physician
  • Valencia, CA
National Provider Identifier
1609971027
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
G32092 Issued in CA
Practice address
25775 McBean Pkwy
Valencia, CA 91355-3708
Phone
(661) 424-8830
Fax
(661) 424-8831
NPI assigned
Sep 13, 2006
Reactivated
Sep 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X G32092 CA Primary

Addresses

Primary practice location

25775 McBean Pkwy
Valencia, CA 91355-3708

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5637

Other identifiers 1

IdentifierTypeStateIssuer
00G320920MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040212000321 CA Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 1850285529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
New York University School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

19950 Rinaldi St
Suite 103
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G32092CAMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Oct 1, 2008 Accepting new patients
Providence Facey Medical Foundation CurrentSince Oct 1, 2008 Accepting new patients
Rinaldi Surgery Center LLC PastSince Apr 10, 2004 Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

19950 Rinaldi St
Ste 200
Porter Ranch, CA 91326
Phone (818) 403-2400

25775 McBean Pkwy
Valencia, CA 91355
Phone (661) 255-6802

23803 McBean Pkwy
Ste 101
Valencia, CA 91355
Phone (661) 481-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rroth350569@oc.providencedirect.org

Organizations & group practices 3

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1609971027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5637",
            "fax_number": "818-837-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553708",
            "telephone_number": "661-424-8830",
            "fax_number": "661-424-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ROBERT",
        "middle_name": "HOWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-09-05",
        "deactivation_date": "2023-08-02",
        "reactivation_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "G32092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G320920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.