Active NPI
Gregory Roth, PHYSICAL THERAPIST
- Physical Therapist
- Worcester, MA
National Provider Identifier
1649446485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9641
- Practice address
- 255 Park Ave
Suite 400
Worcester, MA 01609-1953 - Phone
- (978) 697-4684
- Fax
- (978) 779-6167
- NPI assigned
- May 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9641 | MA | Primary |
Addresses
Primary practice location
255 Park Ave
Suite 400
Worcester, MA 01609-1953
Mailing address
255 Park Ave
Suite 400
Worcester, MA 01609-1953
Phone (978) 697-4684
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AA22686 | Other | MA | HPHC |
| Y68133 | Other | MA | BCBS |
| Y61326 | Other | MA | BCBS |
| 4551239 | Other | MA | CIGNA |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onsite Therapy Solutions, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Worcester, MA
- NPI 1528143252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1649446485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 PARK AVE",
"address_2": "SUITE 400",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091953",
"telephone_number": "978-697-4684",
"fax_number": "978-779-6167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 PARK AVE",
"address_2": "SUITE 400",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091953",
"telephone_number": "978-697-4684",
"fax_number": "978-779-6167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "GREGORY",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-01",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "9641",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC",
"identifier": "AA22686",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y68133",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y61326",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4551239",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.