NPIMap

Individual provider Active NPI

Eira Roth, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1720214901
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
Q5717 Issued in TX
Practice address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301501140 MI
Diagnostic Radiology Physician 2085R0202X Q5717 TX Primary

Addresses

Primary practice location

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Mailing address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151106001528 TX Practitioner - Diagnostic Radiology 4587882105 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

6263 Harry Hines Blvd
Dallas, TX 75235-5217
Phone (214) 645-0624

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044
  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Feb 1, 2021 Accepting new patients
Radiologists Associated in Duluth LTD Diagnostic Radiology CurrentSince Sep 1, 2021 Accepting new patients
Rochester General Hospital Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince May 1, 2021 Accepting new patients
Integrated Imaging Consultants LLC Diagnostic Radiology CurrentSince Dec 1, 2020 Accepting new patients
United Memorial Medical Center Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Rochester General Hospital CurrentSince Aug 1, 2022 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Feb 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2022 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

10 Little Brook Rd
West Wareham, MA 02576

10057 County Road 472
Anna, TX 75409

3500 Gaston Ave
Dallas, TX 75246

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

6263 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 648-3085

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

Organizations & group practices 12

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 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1720214901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "EIRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301501140",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q5717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.