Active NPI
Sara L Roth, MD
- Internal Medicine Physician
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5101014990
- Practice address
- 1105 6TH Street
Traverse City, MI 49684 - Phone
- (231) 947-0673
- Fax
- (801) 740-2847
- NPI assigned
- Feb 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 5101014990 | MI | |
| Hospitalist Physician | 208M00000X | 58841 | MN | |
| Internal Medicine Physician | 207R00000X | 5101014990 | MI | Primary |
Addresses
Primary practice location
1105 6TH Street
Traverse City, MI 49684
Mailing address
36115 Schoolcraft Rd
Livonia, MI 48150-1216
Phone (734) 464-0887
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4780797 | Medicaid | MI | |
| SR014990 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7000
3401 Ludington St
Escanaba, MI 49829-1300
Phone (906) 786-5707
580 W College Ave
Up Health System
Marquette, MI 49855-2736
Phone (906) 228-9440
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101014990 | MI | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of Michigan, PLLC | Internal Medicine | Current | Accepting new patients |
| Sound Inpatient Physicians-Michigan, PLLC | Internal Medicine | Current | Accepting new patients |
| Hospitalist Medicine Physicians of Michigan PLLC | Internal Medicine | Current | Accepting new patients |
| Sound Inpatient Physicians - Michigan, PLLC | Internal Medicine | Current | Accepting new patients |
| Indigo Services, PLC | Emergency Medical Services | Past | Accepting new patients |
Locations
1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000
224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200
1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591
580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131
800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
Interoperability endpoints
- sroth84928@directinfirmaryhealth.org
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Kalamazoo, MI
- NPI 1093967861
-
- Internal Medicine Physician
- Adrian, MI
- NPI 1013180181
-
- Internal Medicine Physician
- Adrian, MI
- NPI 1033370283
-
- Hospitalist Physician
- Escanaba, MI
- NPI 1366768178
Internal Medicine
-
- Hospitalist Physician
- Traverse City, MI
- NPI 1790769669
Emergency Medical Services
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Sault Sainte Marie, MI
- NPI 1619791431
-
- Rural Acute Care Hospital
- Alpena, MI
- NPI 1619914652
-
- Critical Access Hospital
- Escanaba, MI
- NPI 1922058551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1912973389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36115 SCHOOLCRAFT RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481501216",
"telephone_number": "734-464-0887",
"fax_number": "734-402-0254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 6TH STREET",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-947-0673",
"fax_number": "801-740-2847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "SARA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-27",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "MI",
"license": "5101014990",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MN",
"license": "58841",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101014990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4780797",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "SR014990",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.