Jennifer L Roth, FNP-C is a medicare enrolled "Family Medicine" in Baraboo, Wisconsin. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southern Wisconsin Emergency Associates Sc and her current practice location is
1700 Tuttle St, Baraboo, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 355-3800.
Jennifer L Roth is licensed to practice in Arizona (license number 248734) 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 1902495468.
Provider's Profile
| Full Name | Jennifer L Roth |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 1700 Tuttle St, Baraboo, Wisconsin |
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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:
- Jennifer L Roth graduated from nursing school in 2020
NPI Data:
- NPI Number: 1902495468
- Provider Enumeration Date: 01/11/2021
- Last Update Date: 03/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 6608280102
- Enrollment ID: I20220310001768
Medical Identifiers
Medical identifiers for Jennifer L Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902495468 | NPI | - | NPPES |
| 1902495468 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 11004-33 (Wisconsin) | Secondary |
| 207Q00000X | Family Medicine | 248734 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Southern Wisconsin Emergency Associates Sc | 3274561055 | 31 |
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 L Roth allows following entities to bill medicare on her behalf.
| Entity Name | Edgerton Hospital And Health Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154350049
PECOS PAC ID: 7719874502
Enrollment ID: O20040304000743 |
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| Entity Name | Stoughton Hospital Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679558647
PECOS PAC ID: 7012825706
Enrollment ID: O20040402001358 |
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| Entity Name | Southern Wisconsin Emergency Associates Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568538189
PECOS PAC ID: 3274561055
Enrollment ID: O20050802000934 |
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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 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 |
|---|
Jennifer L Roth, FNP-C
1700 Tuttle St,
Baraboo, WI 53913-3319
Ph: (608) 355-3800 | Jennifer L Roth, FNP-C
1700 Tuttle St,
Baraboo, WI 53913-3319
Ph: (608) 355-3800 |
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