Individual provider Active NPI

Stephanie Roth, PT

  • Physical Therapist
  • Mosinee, WI
National Provider Identifier
1790176675
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12778 Issued in WI
Practice address
390 Orbiting Dr
Mosinee, WI 54455-1763
Phone
(715) 693-9188
NPI assigned
Feb 12, 2015
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12778 WI Primary

Addresses

Primary practice location

390 Orbiting Dr
Mosinee, WI 54455-1763

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 1

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2872

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714000531 WI Practitioner - Physical Therapist in Private Practice 5294048765 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12778WIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 21, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Mar 4, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Aug 21, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 21, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 21, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Aug 21, 2023 Accepting new patients
MCHS Hospitals, Inc. CurrentSince Aug 21, 2023 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. Current Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 21, 2023 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Mar 4, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Aug 21, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 6, 2015 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 21, 2023 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

390 Orbiting Dr
Mosinee, WI 54455
Phone (715) 693-9100

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1790176675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 ORBITING DR",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551763",
            "telephone_number": "715-693-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1506 S Oneida St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549151305",
            "country_code": "US",
            "telephone_number": "920-738-2872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "STEPHANIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "390 Orbiting Dr",
            "city": "Mosinee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544551763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mosinee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.