Robert Mark Roth, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

974 Issued in NH

Practice address

1 Medical Center Drive
Lebanon, NH 03756-0001

Phone

(603) 650-7232

Fax

(603) 650-9478

NPI assigned

Dec 4, 2006

Last updated

Jul 8, 2007By 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 2

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

State of New HampshireGroup PAC ID 3870530579, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Merit-based Incentive Payment System (MIPS)

Final score

79.66 of 100Reported as apm

Quality

53.51

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Medicare reassignment Care Compare group NPD
• State of New Hampshire

  dba New Hampshire Hospital

  • Psychiatric Hospital
  • Concord, NH
  • NPI 1861491334
  Medicare reassignment Care Compare group NPD
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment NPD
• Mary Hitchcock Memorial Hospital

  dba Hampstead Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1699584219
  NPD
• State of New Hampshire

  dba Hampstead Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1952450082
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  dba MHMH Regional Services

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  Care Compare affiliation

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891863106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-7232",
            "fax_number": "603-650-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-7232",
            "fax_number": "603-650-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ROBERT",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NH",
            "license": "974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "1008316",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30421662",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan M Ross, M.D.
• Lennon L Ross, PA
• Mark David Rostash
• Diane M Roston, MD
• Sivan Rotenberg, MA, PHD
• Eric S Rothstein, MD
• Richard Ira Rothstein, MD
• Mark Stephen Rouleau
• Joshua Michael Rovner, DO
• David Rozolsky

• Clinical Neuropsychologist in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Clinical Neuropsychologist in New Hampshire

• 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.
• 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.