Zachary D Roth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003761A Issued in IN

Practice address

3301 Lake Ave
Fort Wayne, IN 46805-5529

Phone

(260) 422-3937

Fax

(260) 424-6900

NPI assigned

Aug 29, 2012

Last updated

Mar 2, 2016By the provider in NPPES

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 IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Ophthalmology P CGroup PAC ID 4688611692, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.97 of 100Reported as group

Quality

89.8

Improvement activities

40

Cost

76.84

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zroth@vco.intellechartdirect.net

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.

• Northeast Ophthalmology P C

  • Ophthalmology Physician
  • Fort Wayne, IN
  • NPI 1265418719
  Medicare reassignment Care Compare group NPD
• Northeast Ophthalmology P C

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1235846650

  Optometrist

  NPD

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1821347402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055529",
            "telephone_number": "260-422-3937",
            "fax_number": "260-424-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055529",
            "telephone_number": "260-422-3937",
            "fax_number": "260-424-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ZACHARY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003761A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201197920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Roth, CO
• Daniel Christopher Roth, DO, MBA, MS
• Meredith Roth, PA-C
• Su Roth
• Theresa L Roth, RN
• Holly Nicole Rothenbush, LMFT
• Amanda Rothgeb
• Michale Diane Rothgeb, PTA
• Rachael M Rothgeb, DPT
• Sara M Rothgeb, MSN, FNP-C

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.
• 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.