Kelly Roth, PA-C
Individual provider Active NPI Surgical Physician Assistant · North Franklin, CT
NPI 1760939680 · NPPES record last updated Sep 8, 2016
Key facts
- NPI
- 1760939680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- Practice address
- 82 New Park Ave
North Franklin, CT 06254-1807 - Phone
- (860) 889-7345
- NPI assigned
- Sep 8, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mass General Brigham Medical Group Western Massachusetts Inc
Practice addresses (Care Compare)
10 Denniston PL
Womens Health
Northampton, MA 01060-2052
Phone (413) 586-9866
30 Locust St
Northampton, MA 01060-2052
Phone (413) 582-2441
4 W St
Orthopedics and Sports Medicine
West Hatfield, MA 01088-9562
Phone (413) 586-8200
Hospital & facility affiliations
- Cooley Dickinson Hospital Inc,the
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.8 of 100
- Quality
- 90
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.43
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.45 of 100
- Quality
- 69.96
- Promoting interoperability
- 79
- Improvement activities
- 40
- Cost
- 77.58
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.95 of 100
- Quality
- 83.12
- Improvement activities
- 40
- Cost
- 84.36
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240819000676 | MA | Practitioner - Physician Assistant | 0941589915 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooley Dickinson Hospital Inc | Current | Accepting new patients |
Locations
30 Locust St
Northampton, MA 01060
Phone (413) 582-2000
Interoperability endpoints
- roth.kelly.cdh@direct.partners.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Yes |
Addresses
Primary practice location
82 New Park Ave
North Franklin, CT 06254-1807
Mailing address
82 New Park Ave
North Franklin, CT 06254-1807
Other providers in North Franklin, CT
- Prachi Vijay Patel
- Thomas Brian Patrick
- James W Prichard Jr.
- Jaime Richardson
- William G Richeimer
- Corrie Schmitt
- Lisa A Shea
- Rebecca A. Sheehan
- Emilia Slabinski
- Aaron D Smith
All providers in North Franklin, CT · Surgical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.