Matthew David Roth, MSN FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Ortonville, MI
NPI 1811580442 · NPPES record last updated May 13, 2024
Key facts
- NPI
- 1811580442
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704293971 (MI)
- Practice address
- 540 Douglaston Dr
Ortonville, MI 48462-8525 - Phone
- (248) 390-7392
- NPI assigned
- Feb 15, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Michigan Medical School, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hurley Medical Center
Practice addresses (Care Compare)
1 Hurley Plaza Ground N Clinic
Hurley Nurse Practitioner Group
Flint, MI 48503-5902
Phone (810) 262-9191
1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9191
Hospital & facility affiliations
- Hurley Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.4 of 100
- Quality
- 66.97
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.88
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231129001224 | MI | Practitioner - Nurse Practitioner | 5890143002 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704293971 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hurley Medical Center | Current | Accepting new patients | |
| Hurley Medical Center | Current | Accepting new patients | |
| Pathology Associates Inc PC | Current | Accepting new patients | |
| Hurley Medical Center | Current |
Accepting new patients | |
| Hurley Medical Center | Current |
Accepting new patients | |
| Hurley Medical Center | Nurse Practitioner | Current | Accepting new patients |
| Hurley Medical Center | Nurse Practitioner | Current |
Accepting new patients |
Locations
1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000
1 Hurley Plz
#4E
Flint, MI 48503
Phone (810) 262-9020
Interoperability endpoints
- mroth118546@direct.hurleymc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704293971 | MI | Yes |
Addresses
Primary practice location
540 Douglaston Dr
Ortonville, MI 48462-8525
Mailing address
540 Douglaston Dr
Ortonville, MI 48462-8525
Phone (248) 390-7392
Other practice location 1
1 Hurley Plz # 4E
Flint, MI 48503-5902
Phone (810) 262-9020
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mroth118546@direct.hurleymc.com |
Other providers in Ortonville, MI
- Jamie Ramos
- Recovery Pathways, LLC
- Rite Aid of Michigan Inc
- Rachel Roberts
- Jenny Luella Roelandt
- Maegan Roy
- Ella Salter
- Brandee L Sampson
- Jordan Sanders
- Jodie Kay Sarginson
All providers in Ortonville, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.