Individual provider Active NPI

Stephen Jason Roth, MD

  • Neurology Physician
  • Lynbrook, NY
National Provider Identifier
1801075239
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
245801-1 Issued in NY
Practice address
360 Merrick Rd FL 1
Lynbrook, NY 11563-2526
Phone
(516) 887-3516
Fax
(516) 887-0031
NPI assigned
Nov 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 245801-1 NY Primary

Addresses

Primary practice location

360 Merrick Rd FL 1
Lynbrook, NY 11563-2526

Mailing address

360 Merrick Rd FL 1
Lynbrook, NY 11563-2526
Phone (516) 887-3516

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address records@linc.criterionsdirect.com Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20081001000791 NY Practitioner - Neurology 4789752965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Albert Einstein College of Medicine of Yeshiva University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Neurology ConsultantsGroup PAC ID 8729155239, 8 clinicians

Practice addresses (Care Compare)

777 Sunrise Hwy
Suite 200
Lynbrook, NY 11563-2950
Phone 5168873516108

Hospital & facility affiliations

  • Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as individual
Quality
74.36
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
245801-1NYMDNeurology Physician

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1801075239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRICK RD FL 1",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632526",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRICK RD FL 1",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632526",
            "telephone_number": "516-887-3516",
            "fax_number": "516-887-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "STEPHEN",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "245801-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@linc.criterionsdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "360 Merrick Rd Fl 1",
            "city": "Lynbrook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115632526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

Verify at the official NPI Registry.