MELINDA M ROTH PMHNP
NPI 1154757045
Nurse Practitioner - Psychiatric/Mental Health in Crandon, WI

Q: What is Melinda Roth's NPI number?

The NPI number for Melinda Roth is 1154757045. It was assigned to this individual provider in the NPPES registry on September 24, 2013.

Q: What is Melinda Roth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Melinda Roth was last updated on September 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 24, 2013PECOS EnrolledAccepts Medicare Assignment

3144 VANZILE RD, CRANDON, WI 54520(715) 478-5180(715) 478-5904 Get Directions Write a Review

NPPES record last updated: September 1, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 1, 2022, Sep 14, 2020 (2 updates tracked since 2020).

On this page

About Melinda M Roth Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELINDA M ROTH PMHNP (NPI 1154757045) is an individual psychiatric/mental health provider in Crandon, Wisconsin, licensed in Illinois (277000959) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1154757045

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMELINDA M ROTHCredential: PMHNP

Location Address3144 VANZILE RDCrandon, WI 54520-8149

Mailing Address1100 Beech St Bldg 10Normal, IL 61761-1493 · (309) 463-5800 · Fax (833) 914-2704

Phone(715) 478-5180

Fax(715) 478-5904

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateSeptember 24, 2013

Last NPPES UpdateSeptember 1, 20222 updates tracked since enumeration

NPPES CertifiedMarch 30, 2021

✔ NPI 1154757045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in IL · 277000959

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 209010719 (IL)

3144 VANZILE RD, Crandon, WI 54520

Open in Google Maps ↗

Secondary Practice Locations 2

Location 11100 Beech St Bldg 10Normal, IL 61761-1493 · Phone (309) 463-5800 · Fax (833) 914-2704

Location 2108 W Market StBloomington, IL 61701-3918 · Phone (309) 827-5351 · Fax (309) 829-6808

Other Identifiers 2

Other783333WI · Provider State License

Medicaid35957000WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Melinda M Roth Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698900231

PECOS Enrollment IDI20170920002093

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Melinda Roth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sokaogon Chippewa Community

4.1 mi

Federally Qualified Health Center (FQHC)

3144 VANZILE RD
Crandon, WI 54520

Reassigned Medicare billing, Wisconsin enrollment
14 clinicians in this Medicare group

NPI 1033115456 (715) 478-5180

The Josselyn Center Nfp

223 mi

Mental Health (Including Community Mental Health Center)

100 N ATKINSON RD
Grayslake, IL 60030

Reassigned Medicare billing, Illinois enrollment
138 clinicians in this Medicare group

NPI 1841078714 (847) 441-5600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54520 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Depression Utilization of the PHQ-9 Tool

The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit

31%26 patients

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

96%271 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%641 patients4/55-star benchmark: 99%

Medication Reconciliation

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.

100%24 patients5/55-star benchmark: 100%

Patient-Specific Education

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.

78%65 patients4/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 100% · 50 patients

50%50 patients3/55-star benchmark: 98%

Provide Patient Access

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…

97%65 patients4/55-star benchmark: 100%

Secure Messaging

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…

9%65 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

37%65 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTEN RADLOFF FNP, APNP

Nurse Practitioner (Family)