Jay Edward Roth, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP010741 Issued in PA

Practice address

706 S 11TH St
#3B
Philadelphia, PA 19147-1968

Phone

(215) 913-7381

NPI assigned

Mar 16, 2010

Sex

Male

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vital Healthcare SolutionsGroup PAC ID 3274830336, 107 clinicians

Silver Willow Wellness PCGroup PAC ID 5597271577, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

46.78 of 100Reported as apm

Quality

33.56

Promoting interoperability

0

Improvement activities

40

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.

• Silver Willow Wellness PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Reading, PA
  • NPI 1659164697
  Medicare reassignment Care Compare group NPD
• Vital Healthcare Solutions

  • Psychiatry Physician
  • Sinking Springs, PA
  • NPI 1659736957
  Medicare reassignment Care Compare group NPD
• Meditelecare of Pennsylvania LLC

  • Clinical Psychologist
  • Harrisburg, PA
  • NPI 1396351847
  Medicare reassignment NPD

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1851615066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 S 11TH ST",
            "address_2": "#3B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471968",
            "telephone_number": "215-913-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 S 11TH ST",
            "address_2": "#3B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471968",
            "telephone_number": "215-913-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JAY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP010741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roth Ear, Nose & Throat Associates PC
• Alan Jay Roth, O.D.
• Carol F Roth, L.C.S.W.
• Christopher Geordie Roth, M.D.
• David Roth
• Joel Roth, PT
• Jonathan Roth, MD
• Margaret Roth, CRNP
• Margaret S. Roth, M.S.ED
• Mary Kate Roth, CRNP

• Psychiatric/Mental Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.