Individual provider Active NPI

Michele M Roth-Kauffman

  • Medical Physician Assistant
  • Erie, PA
National Provider Identifier
1649439928
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA001447L Issued in PA
Practice address
135 E 38TH St
Erie, PA 16504-1559
Phone
(814) 871-5645
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA001447L PA Primary

Addresses

Primary practice location

135 E 38TH St
Erie, PA 16504-1559

Mailing address

109 University SQ
Erie, PA 16541-0002
Phone (814) 871-5645

Other names 1

  • Michele M Roth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA001447LPAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1649439928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 UNIVERSITY SQ",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165410002",
            "telephone_number": "814-871-5645",
            "fax_number": "814-871-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041559",
            "telephone_number": "814-871-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH-KAUFFMAN",
        "first_name": "MICHELE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA001447L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "ROTH",
            "middle_name": "M",
            "credential": "JD, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.