Donald Roth, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

104712 Issued in NY

Practice address

111 Maltese Dr
Middletown, NY 10940-2115

Phone

(845) 342-4774

Fax

(845) 343-3295

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• Middletown Medical PC

  • Emergency Medicine Physician
  • Middletown, NY
  • NPI 1902855828

  Family Medicine

  Medicare reassignment NPD
• Middletown Medical PC

  • Cardiac Rehabilitation Clinic/Center
  • Middletown, NY
  • NPI 1174201529
  NPD
• Catskill Regional Medical Center

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1699750281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774",
            "fax_number": "845-343-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774",
            "fax_number": "845-343-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "104712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00182123",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Rosenfeld, PHARMD
• Kristi Ross
• Krystal Ross, RN
• Leslie Ross
• Megan Rossi, LCSW
• David Eric Rothstein, DDS
• Sabrina Janine Rothwell, SPECIAL EDUCATION
• Giuseppina Rotundo
• Krystal Rowe-Young
• Marianne C Rowe, CRNA

• Family Medicine Physician in Middletown, NY
• Providers in Middletown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.