Adam Corgan Roth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010658 Issued in MI

Practice address

2147 Professional Dr
Gaylord, MI 49735-0003

Phone

(989) 732-1753

Fax

(989) 731-1425

NPI assigned

Sep 27, 2021

Last updated

Sep 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Western Michigan Un Homer Stryker School of Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Munson Healthcare Otsego Memorial HospitalGroup PAC ID 8325942535, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
• McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aroth2@direct.mhc.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McLaren Central Michigan

  • General Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1245266063
  Medicare reassignment Care Compare group
• Munson Healthcare Otsego Memorial Hospital

  dba Munson Healthcare OMH Medical Group-Gaylord RHC

  • Rural Health Clinic/Center
  • Gaylord, MI
  • NPI 1164628426
  Medicare reassignment Care Compare group
• Munson Healthcare Grayling

  dba Roscommon Community Health Center

  • Rural Health Clinic/Center
  • Roscommon, MI
  • NPI 1710383351
  Medicare reassignment
• McLaren Central Michigan

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1710235775
  NPD
• McLaren Central Michigan

  • Rural Health Clinic/Center
  • Gladwin, MI
  • NPI 1841812989
  NPD
• Munson Healthcare Grayling

  dba Mio Primary Care

  • Rural Health Clinic/Center
  • Mio, MI
  • NPI 1093349698
  NPD
• Munson Healthcare Otsego Memorial Hospital

  dba MHC Great Lakes Plastic Surgery & Skin Center- Petoskey

  • Plastic Surgery Physician
  • Petoskey, MI
  • NPI 1770374530
  NPD
• Munson Healthcare Otsego Memorial Hospital

  dba Munson Healthcare OMH Medical Group-Gaylord

  • General Practice Physician
  • Gaylord, MI
  • NPI 1821064643
  NPD
• McLaren Central Michigan

  • General Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1538195409
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Central Michigan

  • Rural Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1619941317
  Care Compare affiliation
• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  Care Compare affiliation
• McLaren Northern Michigan

  • General Acute Care Hospital
  • Petoskey, MI
  • NPI 1992812580
  Care Compare affiliation

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1619648805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 PROFESSIONAL DR",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497350003",
            "telephone_number": "989-732-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 PROFESSIONAL DR",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497350003",
            "telephone_number": "989-732-1753",
            "fax_number": "989-731-1425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2585 W Houghton Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Prudenville",
            "state": "MI",
            "postal_code": "486519624",
            "country_code": "US",
            "telephone_number": "989-366-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1996 Walden Dr",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497358241",
            "country_code": "US",
            "telephone_number": "989-731-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ADAM",
        "middle_name": "CORGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.