Mary Kate Roth, CRNP

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

SP027437 Issued in PA

Practice address

111 S 11TH St
Philadelphia, PA 19107-4824

Phone

(215) 955-6060

NPI assigned

Apr 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Einstein Practice Plan Inc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Einstein Practice Plan Inc

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1457304198
  NPD
• Einstein Practice Plan Inc

  • Surgery Physician
  • Philadelphia, PA
  • NPI 1992761621
  NPD (past)

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1821784737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 CHRISTIAN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462314",
            "telephone_number": "240-383-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARY KATE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "PA",
            "license": "SP027437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Edward Roth, CRNP
• Joel Roth, PT
• Jonathan Roth, MD
• Margaret Roth, CRNP
• Margaret S. Roth, M.S.ED
• Maurice Roth, M.D.
• Melanie Anne Roth, MD
• Nancy Lynn Roth, MA
• Susan B Roth, MD
• Roger Rothenberg, MD

• Critical Care Medicine Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Critical Care Medicine Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.