Mary Ellen Roth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3777 Issued in OH

Practice address

4157 Belden Village Mall
Canton, OH 44718-2501

Phone

(330) 494-4140

Fax

(866) 425-2239

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1985

Medicare assignment

May accept Medicare assignment

Group practices

Belden Optometry LLCGroup PAC ID 6709161532, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Belden Optometry LLC

  • Optometrist
  • Canton, OH
  • NPI 1972049716
  Medicare reassignment Care Compare group NPD
• Dr. Richard E. Hults & Assoc., Inc.

  • Optometrist
  • Fairview Park, OH
  • NPI 1548482185
  Medicare reassignment NPD
• Summit Family Vision LLC

  • Optometrist
  • Fairlawn, OH
  • NPI 1962065672
  Medicare reassignment
• Dr. Richard E Hults and Associates, Inc.

  • Optometrist
  • Elyria, OH
  • NPI 1003226820
  NPD
• Dr. Richard E. Hults & Assoc., Inc.

  • Optometrist
  • Canton, OH
  • NPI 1437372208
  NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1912065160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365880",
            "telephone_number": "330-697-4748",
            "fax_number": "866-425-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 BELDEN VILLAGE MALL",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182501",
            "telephone_number": "330-494-4140",
            "fax_number": "866-425-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "3777",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Elizabeth Ross, RN
• Wendy Michelle Ross, RN
• Breana R Rossen, CT, CDCA
• Katelyn Roszkowski
• Adrienne Therese Roth, PCC/LCDC
• Rachel A Roudebush, R.N.
• Stacey Roush
• Amanda Marie Rovnak, LISW, LICDC
• Dakota Rovnak, LSW
• Allen J Rovner, MD

• Optometrist in Canton, OH
• Providers in Canton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.