Individual provider Active NPI

Jeffrey Scott Roth, FNP

  • Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1992424923
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
279848 Issued in AZ
Practice address
1215 N Beaver St
Flagstaff, AZ 86001-3120
Phone
(928) 773-2200
Fax
(928) 773-2300
NPI assigned
Aug 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 279848 AZ
Nurse Practitioner 363L00000X 279848 AZ Primary

Addresses

Primary practice location

1215 N Beaver St
Flagstaff, AZ 86001-3120

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other practice location 1

16196 W Gibson Ln
Goodyear, AZ 85338-3448
Phone (623) 640-4792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230227000246 AZ Practitioner - Nurse Practitioner 2567835374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

340 S Willard St
Cottonwood, AZ 86326-4126
Phone (928) 639-6025

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Pathology Associates Current Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Apr 1, 2023 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine Current Accepting new patients
Head to Toe Health and Wellness Family Medicine CurrentSince Nov 13, 2022 Accepting new patients

Locations

340 S Willard St
Ste 201
Cottonwood, AZ 86326
Phone (928) 634-5551

340 S Willard St
Cottonwood, AZ 86326
Phone (928) 634-5551

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

2000 S Thompson St
Flagstaff, AZ 86001
Phone (928) 213-1051

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

1215 N Beaver St
Ste 20
Flagstaff, AZ 86001

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

Interoperability endpoints

  • Direct secure messaging: jeff@headtotoehealthandwellness.kareodirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1992424923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013120",
            "telephone_number": "928-773-2200",
            "fax_number": "928-773-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16196 W Gibson Ln",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853383448",
            "country_code": "US",
            "telephone_number": "623-640-4792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-08-21",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "279848",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "279848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.