Individual provider Active NPI

Maya Roth

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1679159487
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
336416 Issued in NY
Practice address
1176 5TH Ave FL 9
New York, NY 10029-6503
Phone
(212) 241-7090
Fax
(212) 987-6386
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 336416 NY Primary

Addresses

Primary practice location

1176 5TH Ave FL 9
New York, NY 10029-6503

Mailing address

1176 5TH Ave FL 9
New York, NY 10029-6503
Phone (212) 241-7090

Other practice location 1

1430 Tulane Ave
New Orleans, LA 70112-2632
Phone (504) 988-5216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
336416NYMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1679159487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-7090",
            "fax_number": "212-987-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-7090",
            "fax_number": "212-987-6386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-5216",
            "fax_number": "504-988-7144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "336416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.