Joanna Belle Roth, MS, ACNP-BC is a medicare enrolled "Nurse Practitioner" physician in Goshen, Indiana. Her current practice location is
21764 Omega Ct, Goshen, Indiana. You can reach out to her office (for appointments etc.) via phone at
(574) 891-4920.
Joanna Belle Roth is licensed to practice in Indiana (license number 71002933A) 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 1194975466.
Physician's Profile
Full Name | Joanna Belle Roth |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 21764 Omega Ct, Goshen, Indiana |
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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: 1194975466
- Provider Enumeration Date: 09/24/2008
- Last Update Date: 02/06/2024
Medicare PECOS Information:
- PECOS PAC ID: 2668534363
- Enrollment ID: I20131202001586
Medical Identifiers
Medical identifiers for Joanna Belle Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194975466 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2083B0002X | Preventive Medicine - Obesity Medicine | 71002933A (Indiana) | Secondary |
363LA2100X | Nurse Practitioner - Acute Care | 71002933A (Indiana) | Secondary |
363L00000X | Nurse Practitioner | 71002933A (Indiana) | 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. Joanna Belle Roth allows following entities to bill medicare on her behalf.
Entity Name | Pic Indiana Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1942546890 PECOS PAC ID: 3476790239 Enrollment ID: O20130515000110 |
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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. Joanna Belle 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 |
Joanna Belle Roth, MS, ACNP-BC 21764 Omega Ct, Goshen, IN 46528-7809 Ph: (574) 891-4920 | Joanna Belle Roth, MS, ACNP-BC 21764 Omega Ct, Goshen, IN 46528-7809 Ph: (574) 891-4920 |
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