Individual provider Active NPI

Patrick Jeremy Roth, M.D.

  • Diagnostic Radiology Physician
  • Sayre, PA
National Provider Identifier
1730574591
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD61158049 Issued in WA
Practice address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone
(570) 887-4401
NPI assigned
Mar 30, 2015
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X TRN23059 FL
Diagnostic Radiology Physician 2085R0202X ME151547 FL
Diagnostic Radiology Physician 2085R0202X MD61158049 WA Primary

Addresses

Primary practice location

1 Guthrie SQ
Sayre, PA 18840-1625

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 887-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210702000993 WA Practitioner - Diagnostic Radiology 7416358064 Reassigns benefits to 4 organizations
I20220106002954 VA Practitioner - Diagnostic Radiology 7416358064 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Florida Atlantic University, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

10318 SE Evergreen Hwy
Vancouver, WA 98664-5360
Phone (570) 887-5599

11210 N Mayfair St
Spokane, WA 99218-1600
Phone (570) 888-5858

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.13 of 100Reported as group
Quality
77.56
Promoting interoperability
100
Improvement activities
40
Cost
76.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME151547FLMDDiagnostic Radiology Physician
TRN23059FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Dec 17, 2021 Accepting new patients
University of Virginia Imaging, LLC Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 1, 2023 Accepting new patients
Bath County Community Hospital CurrentSince Jul 1, 2022 Accepting new patients
University of Miami CurrentSince Jun 25, 2021 Accepting new patients
University Hospitals Medical Group Inc Diagnostic Radiology CurrentSince Oct 1, 2021 Accepting new patients
University of Virginia Imaging, LLC Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
University of Virginia Imaging, LLC Diagnostic Radiology Current Accepting new patients
Foundation Radiology Group PC Diagnostic Radiology CurrentSince Jun 25, 2021 Accepting new patients
TRG, LLC Diagnostic Radiology Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1611 NW 12th Ave
Ste 279
Miami, FL 33136
Phone (305) 585-8178

401 Liberty Ave
Ste 2000
Pittsburgh, PA 15222
Phone (412) 325-2800

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

2965 Ivy Rd
#101
Charlottesville, VA 22903
Phone (434) 243-9198

415 Ray C Hunt Dr
#1100
Charlottesville, VA 22903
Phone (434) 243-8189

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

545 Ray C Hunt Dr
Ste 140
Charlottesvle, VA 22903
Phone (434) 243-9198

78 Medical Center Dr
Fishersville, VA 22939
Phone (540) 245-7216

15195 Heathcote Blvd
Ste 350
Haymarket, VA 20169
Phone (571) 284-3180

210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889

Organizations & group practices 11

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.

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1730574591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "PATRICK",
        "middle_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "TRN23059",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME151547",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61158049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

Verify at the official NPI Registry.