Jennifer Roth, MSW is a medicare enrolled "Occupational Therapist" provider in Boulder, Colorado. Her current practice location is
1333 Iris Ave, Boulder, Colorado. You can reach out to her office (for appointments etc.) via phone at
(303) 443-8500.
Jennifer Roth is licensed to practice in Florida (license number OT22592) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104247840.
Healthcare Provider's Profile
| Full Name | Jennifer Roth |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 1333 Iris Ave, Boulder, Colorado |
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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: 1104247840
- Provider Enumeration Date: 12/24/2013
- Last Update Date: 12/07/2022
Medicare PECOS Information:
- PECOS PAC ID: 0840669768
- Enrollment ID: I20221214003311
Medical Identifiers
Medical identifiers for Jennifer Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1104247840 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 225X00000X | Occupational Therapist | OT22592 (Florida) | 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. Jennifer Roth allows following entities to bill medicare on her behalf.
| Entity Name | Healthpro Heritage Rehab & Fitness Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871972653
PECOS PAC ID: 6507832573
Enrollment ID: O20150723009037 |
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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. Jennifer Roth 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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Jennifer Roth, MSW
1333 Iris Ave,
Boulder, CO 80304-2226
Ph: (303) 443-8500 | Jennifer Roth, MSW
1333 Iris Ave,
Boulder, CO 80304-2226
Ph: (303) 443-8500 |
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