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DR. CARL J ROTH III OD
NPI 1174596738
Optometrist in Great Falls, MT

Active since February 13, 2006PECOS EnrolledAccepts Medicare Assignment
2800 11TH AVE S STE 14, GREAT FALLS, MT 59405(406) 455-2020(406) 771-6816 Get Directions Write a Review

NPPES record last updated: December 8, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 8, 2022, Jun 9, 2022, Mar 10, 2022 (3 updates tracked since 2022).

About Dr. Carl J Roth Iii Od NPPES

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

DR. CARL J ROTH III OD (NPI 1174596738) is an individual optometrist in Great Falls, Montana, licensed in Montana (MT675) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Benefis Hospitals Inc, and is a graduate of Pacific University - College Of Optometry (1999).

NPPES Registry Identity

NPI1174596738
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. CARL J ROTH IIICredential: OD
Location Address2800 11TH AVE S STE 14Great Falls, MT 59405-5263
Mailing Address2800 11th Ave S Ste 14Great Falls, MT 59405-5263 · (406) 455-2020 · Fax (406) 771-6816
Phone(406) 455-2020
Fax(406) 771-6816
Sole ProprietorNo
Medical School CMSPacific University - College Of OptometryGraduated 1999
Enumeration DateFebruary 13, 2006
Last NPPES UpdateDecember 8, 20223 updates tracked since enumeration
NPPES CertifiedDecember 8, 2022
✔ NPI 1174596738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MT · MT675
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
2800 11TH AVE S STE 14, Great Falls, MT 59405
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Other Identifiers 4

Other000027131MT · Blue Cross Blue Shield
Medicaid0000481219MT
Other410042781Railroad Medicare
OtherMSF1137622MT · Montana State Fund

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Carl J Roth Iii Od 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 ID9234324351
PECOS Enrollment IDI20101115000189
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.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
478 services257 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
129 services90 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
124 services123 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
116 services92 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
95 services71 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
67 services60 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Benefis Hospitals Inc

Acute Care Hospitals · Great Falls, MT
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270012
Location1101 26th St SGreat Falls, MT 59405 · Cascade County
Emergency services Birthing friendly

Great Falls Clinic Hospital

Acute Care Hospitals · Great Falls, MT
5/5 CMS rating
OwnershipProprietary
CMS Certification Number270086
Location3010 15th Avenue SouthGreat Falls, MT 59405 · Cascade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59405 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
$130.52 typical visit price
range $56.81 – $172.26
Typical copayment $32.63 (range $14.20 – $43.06)
Most-billed visit code 99204
Established Patient
$70.82 typical visit price
range $18.24 – $140.32
Typical copayment $17.70 (range $4.56 – $35.08)
Most-billed visit code 99213
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

Age-Related Macular Degeneration (AMD): Dilated Macular Examination
100%67 patients5/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
100%31 patients5/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care
100%43 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

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

FRED D. ABRAHAM OD
Optometrist
2800 11TH AVE S STE 14
GREAT FALLS, MT 59405
Cascade County (406) 455-2020

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 Carl Roth's NPI number?

The NPI number for Carl Roth is 1174596738. It was assigned to this individual provider in the NPPES registry on February 13, 2006.

Where is Carl Roth located?

Carl Roth practices at 2800 11th Ave S Ste 14, Great Falls, MT 59405. The listed phone number is (406) 455-2020.

What is Carl Roth's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Carl Roth enrolled in Medicare?

Yes. Carl Roth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carl Roth accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and Providence Health Plan list Carl Roth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carl Roth affiliated with any hospitals?

According to CMS data, Carl Roth is affiliated with Benefis Hospitals Inc and Great Falls Clinic Hospital.

When was this NPI record last updated?

The NPPES record for Carl Roth was last updated on December 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.