Ryan L Roth, APRN is a medicare enrolled "Nurse Practitioner" provider in Higganum, Connecticut. She graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Prohealth Physicians Pc and her current practice location is
415 Killingworth Rd, Higganum, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(860) 345-8535.
Ryan L Roth is licensed to practice in Connecticut (license number 5832) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225453517.
Healthcare Provider's Profile
| Full Name | Ryan L Roth |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 10 Years |
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| Location | 415 Killingworth Rd, Higganum, Connecticut |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ryan L Roth graduated from medical school in 2014
NPI Data:
- NPI Number: 1225453517
- Provider Enumeration Date: 02/24/2014
- Last Update Date: 10/17/2019
Medicare PECOS Information:
- PECOS PAC ID: 2466779871
- Enrollment ID: I20150324001485
Medical Identifiers
Medical identifiers for Ryan L Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225453517 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 994473 (Connecticut) | Secondary |
| 163W00000X | Registered Nurse | RN2284731 (Massachusetts) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5832 (Connecticut) | Secondary |
| 363L00000X | Nurse Practitioner | 5832 (Connecticut) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Prohealth Physicians Pc | 1355246950 | 217 |
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. Ryan L Roth allows following entities to bill medicare on her behalf.
| Provider Name | Prohealth Physicians Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1720194053
PECOS PAC ID: 1355246950
Enrollment ID: O20031205000602 |
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| Provider Name | Community Health Services Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1730284605
PECOS PAC ID: 3870564172
Enrollment ID: O20040802000825 |
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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. Ryan L 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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Ryan L Roth, APRN
500 Albany Ave,
Hartford, CT 06120-2508
Ph: (860) 249-9625 | Ryan L Roth, APRN
415 Killingworth Rd,
Higganum, CT 06441-4370
Ph: (860) 345-8535 |
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