NPIMap

Individual provider Active NPI

Jacqueline Marie Roth, M.D.

  • Emergency Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1639505308
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT204174 Issued in PA
Practice address
230 McKee PL
Suite 500
Pittsburgh, PA 15213-3903
Phone
(412) 647-8284
NPI assigned
Sep 25, 2013
Last updated
Sep 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT204174 PA Primary

Addresses

Primary practice location

230 McKee PL
Suite 500
Pittsburgh, PA 15213-3903

Mailing address

5529 Howe St
Apt 1
Pittsburgh, PA 15232-2303
Phone (857) 488-0675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151021000525 PA Practitioner - Emergency Medicine 1254640980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio State University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Medical Facilities IncGroup PAC ID 8325956592, shared by 7 NPIs, 37 clinicians

Practice addresses (Care Compare)

720 Blackburn Rd
Sewickley, PA 15143-1459
Phone (412) 741-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT204174PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Facilities, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Valley Medical Facilities Inc Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Valley Medical Facilities Inc Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Valley Medical Facilities Inc Past Accepting new patients

Locations

1000 Dutch Ridge Rd
Beaver, PA 15009
Phone (724) 728-7000

25 Heckel Rd
Mc Kees Rocks, PA 15136
Phone (412) 777-6161

720 Blackburn Rd
Sewickley, PA 15143
Phone (412) 741-6600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1639505308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5529 HOWE ST",
            "address_2": "APT 1",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152322303",
            "telephone_number": "857-488-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MCKEE PL",
            "address_2": "SUITE 500",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133903",
            "telephone_number": "412-647-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT204174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.