Individual provider Active NPI

David M Roth, OD

  • Optometrist
  • Miami, FL
National Provider Identifier
1922036458
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2436 Issued in FL
Practice address
136 NE 2ND Ave
Miami, FL 33132-2509
Phone
(305) 374-5127
Fax
(305) 374-2123
NPI assigned
Jun 30, 2006
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2436 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OPC2436 FL
Corneal and Contact Management Optometrist 152WC0802X 2436 FL

Addresses

Primary practice location

136 NE 2ND Ave
Miami, FL 33132-2509

Mailing address

136 NE 2ND Ave
Miami, FL 33132-2509
Phone (305) 984-8476

Other identifiers 1

IdentifierTypeStateIssuer
078818000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110818000021 FL Practitioner - Optometry 5597934828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

136 NE 2ND Ave
Miami, FL 33132-2509

136 NE 2ND Ave
Miami, FL 33139
Phone (305) 371-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2436FLMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ashley Roth & Associates PA Optometrist CurrentSince Apr 24, 2022 Accepting new patients

Locations

136 NE 2nd Ave
Miami, FL 33132
Phone (305) 371-2020

Organizations & group practices 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1922036458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 NE 2ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331322509",
            "telephone_number": "305-984-8476",
            "fax_number": "305-532-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 NE 2ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331322509",
            "telephone_number": "305-374-5127",
            "fax_number": "305-374-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2436",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC2436",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "2436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078818000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.