Active NPI
Andrea Catherine Roth
- Psychologist
- Yonkers, NY
National Provider Identifier
1770919805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301017528
- Practice address
- 1156 N Broadway
Yonkers, NY 10701-1108 - Phone
- (914) 965-3700
- Fax
- (914) 798-5549
- NPI assigned
- Sep 20, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301017528 | MI | Primary |
Addresses
Primary practice location
1156 N Broadway
Yonkers, NY 10701-1108
Mailing address
1156 N Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285628552 | Other | NY | AGENCY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 20, 2024 through Feb 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301017528 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1770919805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1156 N BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107011108",
"telephone_number": "914-965-3700",
"fax_number": "914-798-5549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1156 N BROADWAY",
"city": "YONKERS",
"state": "NY",
"postal_code": "107011108",
"telephone_number": "914-965-3700",
"fax_number": "914-798-5549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "ANDREA",
"middle_name": "CATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-20",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301017528",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY",
"identifier": "1285628552",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.