Individual provider Active NPI

Eden Roth, DO

  • Physical Medicine & Rehabilitation Physician
  • Rochester, MI
National Provider Identifier
1649854282
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101028616 Issued in MI
Practice address
1135 W University Dr Ste 175
Rochester, MI 48307-1893
Phone
(248) 660-5882
NPI assigned
May 10, 2021
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101028616 MI Primary

Addresses

Primary practice location

1135 W University Dr Ste 175
Rochester, MI 48307-1893

Mailing address

1135 W University Dr Ste 175
Rochester, MI 48307-1893
Phone (248) 650-5861

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250716004079 MI Practitioner - Physical Medicine and Rehabilitation 9234539537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialists in Rehabilitation Medicine PCGroup PAC ID 1759450323, 31 clinicians

Practice addresses (Care Compare)

43344 Woodward Ave
Bloomfield Hills, MI 48302-5014
Phone (248) 335-9099

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101028616MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialists in Rehabilitation Medicine PC Physical Medicine & Rehabilitation CurrentSince Sep 2, 2025 Accepting new patients

Locations

43344 Woodward Ave
Bloomfld Hls, MI 48302
Phone (248) 335-9099

9640 Commerce Rd
Ste 202
Commerce Twp, MI 48382
Phone (248) 360-8660

1135 W University Dr
Ste 175
Rochester Hls, MI 48307
Phone (248) 650-4738

1135 W University Dr
Ste 425
Rochester Hls, MI 48307
Phone (248) 650-5861

Interoperability endpoints

  • Direct secure messaging: edenroth@sirmp-mi.direct.office.nextgen.com

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

Hospital & facility affiliations 7

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": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1649854282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR STE 175",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071893",
            "telephone_number": "248-650-5861",
            "fax_number": "248-650-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 W UNIVERSITY DR STE 175",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071893",
            "telephone_number": "248-660-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "EDEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101028616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.