Marvin Allen Roth, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA01947300 Issued in NJ

Practice address

403 Cedarbrook Lane
Linwood, NJ 08221

Phone

(609) 408-8635

Fax

(609) 601-1538

NPI assigned

Mar 20, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• State of New Jersey Omb Centralized Payroll

  dba Woodbine Developmental Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Woodbine, NJ
  • NPI 1982642641
  Medicare reassignment NPD
• State of New Jersey Omb Centralized Payroll

  dba Greystone Park Psychiatric Hospital

  • Psychiatric Hospital
  • Morris Plains, NJ
  • NPI 1336221878
  NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902921166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 CEDARBROOK LANE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "08221",
            "telephone_number": "609-408-8635",
            "fax_number": "609-601-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 CEDARBROOK LANE",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "08221",
            "telephone_number": "609-408-8635",
            "fax_number": "609-601-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARVIN",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA01947300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00014756V",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Cortes Schwartz Mental Health Associates
• Shelley Lynne Rosenfeld, PH.D.
• Rosewood Womens Health Partners
• Amanda Rae Ross, OTR/L
• Roth Occupational Therapy LLC
• Ruffin Associates Healthy Housecalls LLC (Ruffin Associates LLC)
• Judith S Ruffin, MD
• Larider Ruffin, DNP, APN, FAAN
• Cheryl Susan Rush, MSN APRN, BC
• Paul Rutledge

• Family Medicine Physician in Linwood, NJ
• Providers in Linwood, NJ by specialty
• Family Medicine Physician in New Jersey

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.