Individual provider Active NPI

Jon J Roth

  • Hospitalist Physician
  • Encinitas, CA
National Provider Identifier
1912093923
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
C50622 Issued in CA
Practice address
354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone
(760) 230-2251
Fax
(760) 230-2253
NPI assigned
Oct 5, 2006
Last updated
Nov 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C50622 CA
Hospitalist Physician 208M00000X C50622 CA Primary

Addresses

Primary practice location

354 Santa Fe Dr
Encinitas, CA 92024-5142

Mailing address

PO Box 231189
Encinitas, CA 92023-1189
Phone (760) 230-2251

Other identifiers 2

IdentifierTypeStateIssuer
000713416OtherAETNA
030471215OtherTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190529000530 WA Practitioner - Internal Medicine 7214824093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C50622CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Dec 25, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Dec 25, 2019 Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Encinitas Palliative Care Associates, Inc. Internal Medicine Past Accepting new patients
East County Neurology Associates, Inc. PastSince Dec 30, 2008 Accepting new patients
Suman K Sinha MD a Medical Corporation Past Accepting new patients

Locations

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1912093923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231189",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920231189",
            "telephone_number": "760-230-2251",
            "fax_number": "760-230-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 SANTA FE DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245142",
            "telephone_number": "760-230-2251",
            "fax_number": "760-230-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C50622",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C50622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "000713416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "030471215",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.