Individual provider Active NPI

James A Roth, MD

  • Clinical Cardiac Electrophysiology Physician
  • Milwaukee, WI
National Provider Identifier
1679527618
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
36221 Issued in WI
Practice address
9200 W Wisconsin Ave
Division of Cardiology and Electrophysiology
Milwaukee, WI 53226-3522
Phone
(414) 805-6204
Fax
(414) 890-5877
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 36221 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X 36221 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Division of Cardiology and Electrophysiology
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Division of Cardiology and Electrophysiology
Milwaukee, WI 53226-3522
Phone (414) 805-6204

Other practice location 1

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8230

Other practice location 2

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8230

Other identifiers 2

IdentifierTypeStateIssuer
1679527618MedicaidWI
002000139POtherHUMANA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jroth331108@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040305000680 WI Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1153219738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

16650 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5959
Phone (262) 827-9200

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

3212 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 334-6165

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 923-7400

4805 S Moorland Rd
New Berlin, WI 53151-7401
Phone (262) 798-7700

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

W180 N8065 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 251-1000

W180N8071 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 253-2700

W180N8085 Town Hall Rd
Suite 301
Menomonee Falls, WI 53051-3518
Phone (262) 257-3200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36221WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Jan 14, 1995 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

Interoperability endpoints

  • Direct secure messaging: jrothmd5560@direct.froedtert.com
  • Direct secure messaging: jroth331108@direct-ehr-ssmhc.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1679527618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DIVISION OF CARDIOLOGY AND ELECTROPHYSIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6204",
            "fax_number": "414-890-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
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            "address_2": "DIVISION OF CARDIOLOGY AND ELECTROPHYSIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6204",
            "fax_number": "414-890-5877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-8230",
            "fax_number": "920-926-8997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 E Division St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549354560",
            "country_code": "US",
            "telephone_number": "920-926-8230",
            "fax_number": "920-926-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "36221",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "36221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679527618",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000139P",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jroth331108@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jroth331108@direct-ehr-ssmhc.com",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.