Nicole Y Roth, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60964584 Issued in WA

Practice address

560 Catalina Dr Ste 200
Ashland, OR 97520-1605

Phone

(541) 201-4850

NPI assigned

Apr 25, 2016

Last updated

Mar 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mrs. Nicole Y Coppage Professional name

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

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
• Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  Medicare reassignment Care Compare group NPD
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Accentcare Home Health of Rogue Valley, LLC

  • Home Health Agency
  • Medford, OR
  • NPI 1912228727
  Care Compare affiliation
• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  Care Compare affiliation

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1689029852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 CATALINA DR STE 200",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201605",
            "telephone_number": "541-201-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 CATALINA DR STE 200",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201605",
            "telephone_number": "541-201-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "NICOLE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2021-03-12",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "ML60677475",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60964584",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60964584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON DEPARTMENT OF HEALTH",
            "identifier": "MD201104",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "COPPAGE",
            "middle_name": "Y",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Robin L. Rose, MD
• Yaffa Rosenthal
• Nara Rosser, RN
• Pamela J Rossio, PMHNP
• Paul Rostykus, MD
• Jeremy Rothenberg, L.AC.
• Alicia Rowe, CADC & QMHA
• Ilene Karen Rubinstein, DC
• Janet Lois Rueger, D.C.
• Wendy Lee Rundel, L.M.T.

• Family Medicine Physician in Ashland, OR
• Providers in Ashland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.