Dr Ronald Carl Roth, MD is a medicare enrolled "Otolaryngology" physician in South Lake Tahoe, California. His current practice location is
2169 South Ave, South Lake Tahoe, California. You can reach out to his office (for appointments etc.) via phone at
(530) 543-5815.
Dr Ronald Carl Roth is licensed to practice in California (license number G27020) 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 1043254907.
Physician's Profile
Full Name | Dr Ronald Carl Roth |
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Gender | Male |
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Speciality | Otolaryngology |
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Location | 2169 South Ave, South Lake Tahoe, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043254907
- Provider Enumeration Date: 06/15/2006
- Last Update Date: 07/16/2014
Medicare PECOS Information:
- PECOS PAC ID: 9133133614
- Enrollment ID: I20090304000610
Medical Identifiers
Medical identifiers for Dr Ronald Carl Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043254907 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Y00000X | Otolaryngology | G27020 (California) | Primary |
207Y00000X | Otolaryngology | 13744 (Nevada) | Secondary |
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. Dr Ronald Carl Roth allows following entities to bill medicare on his behalf.
Entity Name | Tahoe Carson Valley Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1508865528 PECOS PAC ID: 8426048158 Enrollment ID: O20040514000834 |
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Entity Name | Barton Healthcare System |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1235196015 PECOS PAC ID: 1850293960 Enrollment ID: O20040915000806 |
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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. Dr Ronald Carl 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 |
Dr Ronald Carl Roth, MD 1111 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 Ph: (530) 543-5659 | Dr Ronald Carl Roth, MD 2169 South Ave, South Lake Tahoe, CA 95150-7059 Ph: (530) 543-5815 |
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