Jerome K Roth Jr, MD is a medicare enrolled "Urology" physician in Sharon, Connecticut. His current practice location is
17 Hospital Hill Rd, Sharon, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 364-0225.
Jerome K Roth Jr is licensed to practice in Connecticut (license number 019211) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1538132972.
Physician's Profile
| Full Name | Jerome K Roth Jr |
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| Gender | Male |
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| Speciality | Urology |
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| Location | 17 Hospital Hill Rd, Sharon, Connecticut |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538132972
- Provider Enumeration Date: 02/08/2006
- Last Update Date: 03/30/2016
Medicare PECOS Information:
- PECOS PAC ID: 9133224645
- Enrollment ID: I20110126000741
Medical Identifiers
Medical identifiers for Jerome K Roth Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538132972 | NPI | - | NPPES |
| 001192111 | Medicaid | CT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | 019211 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jerome K Roth Jr allows following entities to bill medicare on his behalf.
| Entity Name | Nuvance Health Medical Practice Ct Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407898117
PECOS PAC ID: 4789597691
Enrollment ID: O20031205000130 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jerome K Roth Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jerome K Roth Jr, MD
Po Box 1736, 17 Hospital Hill Rd,
Sharon, CT 06069
Ph: (860) 364-0225 | Jerome K Roth Jr, MD
17 Hospital Hill Rd,
Sharon, CT 06069
Ph: (860) 364-0225 |
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