Individual provider Active NPI

Kelly Roth, PA-C

  • Surgical Physician Assistant
  • North Franklin, CT
National Provider Identifier
1760939680
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
82 New Park Ave
North Franklin, CT 06254-1807
Phone
(860) 889-7345
NPI assigned
Sep 8, 2016
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

82 New Park Ave
North Franklin, CT 06254-1807

Mailing address

82 New Park Ave
North Franklin, CT 06254-1807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819000676 MA Practitioner - Physician Assistant 0941589915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
69.96
Promoting interoperability
79
Improvement activities
40
Cost
77.58

Merit-based Incentive Payment System (MIPS)

Final score
87.95 of 100Reported as group
Quality
83.12
Improvement activities
40
Cost
84.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince Aug 11, 2025 Accepting new patients
Cooley Dickinson Hospital Inc Current Accepting new patients

Locations

170 University Dr
Amherst, MA 01002
Phone (413) 461-3530

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

Interoperability endpoints

  • Direct secure messaging: roth.kelly.cdh@direct.partners.masshiway.net

Organizations & group practices 3

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 2

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1760939680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 NEW PARK AVE",
            "city": "NORTH FRANKLIN",
            "state": "CT",
            "postal_code": "062541807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 NEW PARK AVE",
            "city": "NORTH FRANKLIN",
            "state": "CT",
            "postal_code": "062541807",
            "telephone_number": "860-889-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Franklin, CT

Sources for this page

Verify at the official NPI Registry.