DR. MARK D ROTH MD
NPI 1144210279
Surgery in Waynesboro, PA
NPI Status: Active since October 28, 2005
Contact Information
45 ROADSIDE AVE
WAYNESBORO, PA
ZIP 17268
Phone: (717) 762-7155
Fax: (717) 762-6929
- Individual
- Male
- Surgery
- PECOS Enrolled
- Medicare Quality Reporting
About MARK ROTH
This page provides the complete NPI Profile along with additional information for Mark Roth, a provider established in Waynesboro, Pennsylvania with a medical specialization in Surgery. The healthcare provider is registered in the NPI registry with number 1144210279 assigned on October 2005. The practitioner's primary taxonomy code is 208600000X with license number MD060014L (PA). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1144210279
- Provider Name
- DR. MARK D ROTH MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 45 ROADSIDE AVE WAYNESBORO, PA 17268
- Location Phone
- (717) 762-7155
- Location Fax
- (717) 762-6929
- Mailing Address
- 785 5TH AVENUE SUITE 3 CHAMBERSBURG, PA 17201
- Mailing Phone
- (717) 263-9555
- Mailing Fax
- (717) 762-6929
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-28-2005
- Last Update Date
- 03-07-2023
- Code Navigator
A surgeon like Mark Roth treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD060014L
- License State
- PA
- Taxonomy Description
- A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 25-1716306 | OTHER (01) | PA | MULTIPLAN/PHCS |
| 546216-01 | OTHER (01) | MD | MD BLUE SHIELD |
| 367632 | OTHER (01) | PA | MAMSI |
| 6720367 | OTHER (01) | PA | AETNA HMO |
| 867633 | OTHER (01) | PA | MEDICARE GROUP # |
| P00700657 | OTHER (01) | PA | RAILROAD MEDICARE |
| 02195701 | OTHER (01) | PA | CAPITAL BLUE CROSS |
| 25-1716306 | OTHER (01) | PA | INFORMED |
| 25-1716306 | OTHER (01) | PA | DEVON |
| 25-1716306 | OTHER (01) | PA | HEALTHNET/TRICARE |
| 990003822 | OTHER (01) | PA | MEDICARE RAILROAD RETIRE |
| 1007307260034 | OTHER (01) | PA | MEDICAID GROUP # |
| 25-1716306 | OTHER (01) | PA | GREATWEST HEALTHCARE |
| 5234477 | OTHER (01) | PA | AETNA HMO |
| 25-1716306 | OTHER (01) | PA | SOUTH CENTRAL PREFERRED |
| 257729 | OTHER (01) | PA | UNISON |
| 908528 | OTHER (01) | PA | HIGHMARK BLUESHIELD |
| G920-0109/233CCU | OTHER (01) | PA | CAREFIRST |
| MD060014L | OTHER (01) | PA | LICENSE |
| 0016462400002 | MEDICAID (05) | PA | |
| 1561881 | OTHER (01) | PA | GATEWAY |
| 120420403 | OTHER (01) | PA | DEPT OF LABOR |
| 25-1716306 | OTHER (01) | PA | FIRST HEALTH |
| 267632 | OTHER (01) | MD | MAMSI OP CHOICE |
| 25-1716306 | OTHER (01) | PA | HEALTH AMERICA |
| 25-1716306 | OTHER (01) | PA | INTERGROUP |
| 5234477 | OTHER (01) | PA | AETNA NON-HMO |
| 810688 | OTHER (01) | PA | AETNA PPO |
Medicare Participation & PECOS Enrollment Status
Mark Roth is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 17268 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.88
- Minimum New Patient Price $54.64
- Maximum New Patient Price $166.87
- Average New Patient Copayment $21.22
- Minimum New Patient Copayment $13.66
- Maximum New Patient Copayment $41.71
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.36
- Minimum Established Patient Price $17.33
- Maximum Established Patient Price $135.84
- Average Established Patient Copayment $17.09
- Minimum Established Patient Copayment $4.33
- Maximum Established Patient Copayment $33.96
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| e-Prescribing | 92% | 162 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 258 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 13% | 398 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 96% | 398 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 62% | 398 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1144210279, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144210279, enumerated as an "individual" on October 28, 2005.
The provider is located at 45 ROADSIDE AVE WAYNESBORO, PA 17268 and the phone number is (717) 762-7155.
Surgery with taxonomy code 208600000X.
The provider might be accepting Accepts: Private Healthcare Systems (PHCS), Medicare,. Please consult your insurance carrier or call the provider to verify.
