Individual provider Active NPI

Madison Roth, OD

  • Optometrist
  • Columbus, OH
National Provider Identifier
1902599418
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.007138 Issued in OH
Practice address
1664 Neil Ave
Columbus, OH 43201-2333
Phone
(614) 292-2020
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.007138 OH Primary

Addresses

Primary practice location

1664 Neil Ave
Columbus, OH 43201-2333

Mailing address

299 Wagon Wheel TRL
Wexford, PA 15090-9328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20230616001082 OH Practitioner - Optometry 2062870470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio State UniversityGroup PAC ID 6103866207, 42 clinicians
Professional Visioncare, LLCGroup PAC ID 7911961370, 13 clinicians

Practice addresses (Care Compare)

1664 Neil Ave
Columbus, OH 43201-2333
Phone (614) 292-2020

185 S State St
Westerville, OH 43081-2232
Phone (614) 898-9989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.007138OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Visioncare LLC Optometrist CurrentSince Oct 18, 2023 Accepting new patients
Professional Visioncare LLC Optometrist CurrentSince Oct 18, 2023 Accepting new patients
Ohio State University CurrentSince Jun 12, 2023 Accepting new patients
Ohio State University Optometrist CurrentSince Jun 12, 2023 Accepting new patients
Professional Visioncare LLC Optometrist Current Accepting new patients
Professional Visioncare LLC Optometrist Past Accepting new patients

Locations

1664 Neil Ave
Columbus, OH 43201
Phone (614) 292-2020

39 S Main St
Johnstown, OH 43031
Phone (614) 898-9989

7100 Graphics Way
Ste 3200
Lewis Center, OH 43035
Phone (614) 898-9989

1800 Zollinger Rd
Ste 1500
Upper Arlington, OH 43221
Phone (614) 366-3937

185 S State St
Westerville, OH 43081
Phone (614) 898-9989

937 Polaris Woods Blvd
Ste B
Westerville, OH 43082
Phone (614) 898-5285

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1902599418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 WAGON WHEEL TRL",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012333",
            "telephone_number": "614-292-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MADISON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.