Active NPI
Sheldon Roth, M.D.
- Psychiatry Physician
- Waban, MA
National Provider Identifier
1891836813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 29875
- Practice address
- 1765 Beacon St
Waban, MA 02468-1402 - Phone
- (617) 332-6150
- Fax
- (617) 527-6677
- NPI assigned
- Feb 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 29875 | MA | Primary |
Addresses
Primary practice location
1765 Beacon St
Waban, MA 02468-1402
Mailing address
1765 Beacon St
Waban, MA 02468-1402
Phone (617) 332-6150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29875 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheldon Roth MD PC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Waban, MA
- NPI 1326189341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891836813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1765 BEACON ST",
"city": "WABAN",
"state": "MA",
"postal_code": "024681402",
"telephone_number": "617-332-6150",
"fax_number": "617-527-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 BEACON ST",
"city": "WABAN",
"state": "MA",
"postal_code": "024681402",
"telephone_number": "617-332-6150",
"fax_number": "617-527-6677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "SHELDON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "29875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waban, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.