Mr Jeffrey Scott Roth, FNP is a medicare enrolled "Nurse Practitioner" physician in Flagstaff, Arizona. His current practice location is
1215 N Beaver St, Flagstaff, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 773-2200.
Mr Jeffrey Scott Roth is licensed to practice in Arizona (license number 279848) 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 1992424923.
Physician's Profile
| Full Name | Mr Jeffrey Scott Roth |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Location | 1215 N Beaver St, Flagstaff, Arizona |
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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: 1992424923
- Provider Enumeration Date: 08/23/2022
- Last Update Date: 08/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567835374
- Enrollment ID: I20230227000246
Medical Identifiers
Medical identifiers for Mr Jeffrey Scott Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1992424923 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 279848 (Arizona) | Secondary |
| 363L00000X | Nurse Practitioner | 279848 (Arizona) | 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. Mr Jeffrey Scott Roth allows following entities to bill medicare on his behalf.
| Entity Name | Northern Arizona Healthcare Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669914552
PECOS PAC ID: 3577473362
Enrollment ID: O20170801003409 |
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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. Mr Jeffrey Scott 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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Mr Jeffrey Scott Roth, FNP
1200 N Beaver St,
Flagstaff, AZ 86001-3118
Ph: (928) 213-6235 | Mr Jeffrey Scott Roth, FNP
1215 N Beaver St,
Flagstaff, AZ 86001-3120
Ph: (928) 773-2200 |
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