Mark Allan Roth, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301109169 Issued in MI

Practice address

26715 Greenfield Rd
Southfield, MI 48076-4717

Phone

(216) 870-0974

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mi Pacs 2 PC

  • Hospitalist Physician
  • Northville, MI
  • NPI 1205418357
  Medicare reassignment NPD
• Michigan Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Brighton, MI
  • NPI 1669901567
  Medicare reassignment NPD
• CS Pacs 3 Midwest LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1972368785

  Internal Medicine, MI

  Medicare reassignment NPD
• Botsford Continuing Care Corporation

  • Skilled Nursing Facility
  • Farmington Hills, MI
  • NPI 1356374185
  NPD (past)
• Southfield Opco LLC

  • Skilled Nursing Facility
  • Southfield, MI
  • NPI 1760823074
  NPD (past)
• Sterling Heights Opco LLC

  • Skilled Nursing Facility
  • Sterling Heights, MI
  • NPI 1174964480
  NPD (past)
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1801998893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25223 PRAIRIE DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26715 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764717",
            "telephone_number": "216-870-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301109169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463430",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Nichole Ross
• Joy Ross, MSW
• Tristica Ross
• Grace Jules Rost, RBT
• Ellen Rotblatt, MD
• Nechama Rothkopf, PMHNP
• Elana Judith Rothstein
• Shoshana Rothstein, DO
• Grace Eva Rotter
• Hiba Kassab Roumayah

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.