MARY EILEEN ROTH FNP-BC
NPI 1164094843
Nurse Practitioner - Family in Chicago, IL
About Mary Eileen Roth Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY EILEEN ROTH FNP-BC (NPI 1164094843) is an individual family provider in Chicago, Illinois, licensed in Illinois (209034461) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Eileen Roth Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60654 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Roth's NPI number?
The NPI number for Mary Roth is 1164094843. It was assigned to this individual provider in the NPPES registry on July 13, 2021. The provider is also known as Mary Eileen Gerardo.
Where is Mary Roth located?
Mary Roth practices at 344 W Hubbard St, Chicago, IL 60654. The listed phone number is (312) 222-2570.
What is Mary Roth's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mary Roth enrolled in Medicare?
Yes. Mary Roth is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Mary Roth was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Mary Eileen Roth, FNP-BC · NPI 1164094843
Family physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since July 13, 2021.
## Identity
- **NPI:** 1164094843 (Entity type: Individual)
- **Enumerated:** July 13, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209034461 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 344 W HUBBARD ST, Chicago, IL 60654-4407
- **Phone:** (312) 222-2570
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1164094843) · Data from the CMS NPPES public registry.