Active NPI
Charles B Roth
- Physician Assistant
- Margaretville, NY
National Provider Identifier
1679527956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000212
- Practice address
- 42084 State Highway 28
Margaretville, NY 12455-2820 - Phone
- (845) 586-2631
- Fax
- (845) 586-2976
- NPI assigned
- May 20, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000212 | NY | Primary |
Addresses
Primary practice location
42084 State Highway 28
Margaretville, NY 12455-2820
Mailing address
42084 State Highway 28
Margaretville, NY 12455-2820
Phone (845) 586-2631
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)
- Not enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Margaretville Memorial Hospital | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679527956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42084 STATE HIGHWAY 28",
"city": "MARGARETVILLE",
"state": "NY",
"postal_code": "124552820",
"telephone_number": "845-586-2631",
"fax_number": "845-586-2976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42084 STATE HIGHWAY 28",
"city": "MARGARETVILLE",
"state": "NY",
"postal_code": "124552820",
"telephone_number": "845-586-2631",
"fax_number": "845-586-2976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "CHARLES",
"middle_name": "B",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "000212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Margaretville, NY
- Randy N Moore, PHARMACIST
- New York Medical Physician Associates PC
- Pill Mill Inc. (Millers Drug Store)
- Prime Care Physicians, P.L.L.C. (MidValley Cardiology)
- Benoni Quansah, PHARMD
- Helen Claire Russell- Tari, OTR/L
- Aaryn Spaulding, LCAT
- St Peters Health Partners Medical Associates, PC
- State of New York Comptrollers Office
- Christine Mary Via, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.