Individual provider Active NPI

Gabrielle Roth, PA-C

  • Physician Assistant
  • Sarasota, FL
National Provider Identifier
1942926597
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116610 Issued in FL
Practice address
1921 Waldemere St
Sarasota, FL 34239-2943
Phone
(941) 952-4001
Fax
(941) 952-4028
NPI assigned
Oct 17, 2022
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9116610 FL Primary

Addresses

Primary practice location

1921 Waldemere St
Sarasota, FL 34239-2943

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other practice location 1

8268 Larkspur Cir
Sarasota, FL 34241-1001
Phone (727) 678-8314

Other identifiers 1

IdentifierTypeStateIssuer
PA9116610OtherFLMED LIC

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223002571 FL Practitioner - Physician Assistant 4486027315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami Trail
FPG Central Billing Office
Sarasota, FL 34239-3509

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

1921 Waldemere St
Sarasota, FL 34239-2941

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Physician Assistant CurrentSince Apr 3, 2023 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

1921 Waldemere St
Sarasota, FL 34239
Phone (941) 914-2600

1921 Waldemere St
Ste 301
Sarasota, FL 34239
Phone (941) 357-1673

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1921 Waldemere St
Ste 504
Sarasota, FL 34239
Phone (941) 917-1579

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: gabrielle.roth@fpg.directbygreenway.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1942926597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392943",
            "telephone_number": "941-952-4001",
            "fax_number": "941-952-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8268 Larkspur Cir",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342411001",
            "country_code": "US",
            "telephone_number": "727-678-8314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LIC",
            "identifier": "PA9116610",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.