Lisa M Roten, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

K8462 Issued in TX

Practice address

1500 Cooper St
Fort Worth, TX 76104-2710

Phone

(682) 885-2140

Fax

(817) 332-2506

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Cardiovascular Disease (Cardiology)Also: Pediatric Medicine

Education

University of South Carolina School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cook Childrens Physician NetworkGroup PAC ID 7719884584, 307 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cook Childrens Medical Center Hospital, Fort Worth, TX, CCN 453300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lroten16699@cookchildrens.direct-ci.com

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment Care Compare group NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD

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

• Cook Children'S Medical Center

  • Urgent Care Clinic/Center
  • Southlake, TX
  • NPI 1134422884

  Hospital

  Care Compare affiliation
• Cook Children'S Medical Center

  • Ambulatory Surgical Clinic/Center
  • Fort Worth, TX
  • NPI 1720059785

  Hospital

  Care Compare affiliation
• Cook Children'S Medical Center

  • Children's Hospital
  • Fort Worth, TX
  • NPI 1891765178
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1750489993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99371",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990371",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042710",
            "telephone_number": "682-885-2140",
            "fax_number": "817-332-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTEN",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "K8462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lroten16699@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1500 Cooper St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tara Ross, LPC
• Marie Sabine Elisa Rosse Griggs, RBT
• Sydney Rossow
• Whitney Rostis, M.S., CCC-SLP
• Roswell Procedural Medicine Associates
• Jessica Ann Roth
• John T. Roth, AU.D.
• Thomas A Rothenbach, M.D.
• Ana L. Rothschild
• Easton Brady Rothwell, DO

• Pediatric Cardiology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.