Amelia Bogart Roth, M.D.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

MD155302 Issued in OR

Practice address

901 E 18TH Ave
Eugene, OR 97403-1354

Phone

(541) 346-3575

NPI assigned

Dec 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amelia.roth.p1@direct.lanecounty.nextgenshare.com
• Direct secure messaging: amelia.roth.1@17792.direct.athenahealth.com

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.

• Lane County Oregon

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314

  Multi-Specialty

  Medicare reassignment NPD
• Umpqua Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1396751772

  Multi-Specialty

  Medicare reassignment NPD
• Umpqua Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sutherlin, OR
  • NPI 1619399888
  NPD
• Umpqua Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1720803810
  NPD

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1659516557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031354",
            "telephone_number": "541-346-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031354",
            "telephone_number": "541-346-3575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-418-5170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "AMELIA",
        "middle_name": "BOGART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD155302",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OR",
            "license": "MD155302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD155302",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Rossberg, OTR/L
• Julie Mathey Rossberg, LMT
• Aubrey Lurlyne Rossi, MS
• Kellyn Rost, LMT
• Jenna Rotach
• Debra Roth, PA-C
• John R Roth, MPAS, PA-C
• Roberta Roth, LCSW
• Zachary Austin Roth, PA
• Matthew Rothermund

• Developmental - Behavioral Pediatrics Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Developmental - Behavioral Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.