DR. JACOB ROTH DPM
NPI 1205398724
Podiatrist - Foot & Ankle Surgery in Hollywood, FL
About Dr. Jacob Roth Dpm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB ROTH DPM (NPI 1205398724) is an individual foot & ankle surgery provider in Hollywood, Florida, licensed in Pennsylvania (SC007030) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jacob Roth Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jacob Roth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hollywood, FL 33021
- Reassigned Medicare billing, Florida enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
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 Jacob Roth's NPI number?
The NPI number for Jacob Roth is 1205398724. It was assigned to this individual provider in the NPPES registry on April 3, 2019.
Where is Jacob Roth located?
Jacob Roth practices at 4000 Hollywood Blvd Ste 745S, Hollywood, FL 33021. The listed phone number is (585) 474-4589.
What is Jacob Roth's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Jacob Roth enrolled in Medicare?
Yes. Jacob Roth is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jacob Roth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Roth reassigns Medicare benefits to Soflo Podiatry LLC (Hollywood, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacob Roth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jacob Roth was last updated on March 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.
# Dr. Jacob Roth, DPM · NPI 1205398724
Foot & Ankle Surgery provider in Hollywood, Florida. Individual provider, active in the CMS NPPES registry since April 3, 2019.
## Identity
- **NPI:** 1205398724 (Entity type: Individual)
- **Enumerated:** April 3, 2019
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** SC007030 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4000 HOLLYWOOD BLVD STE 745S, Hollywood, FL 33021-1218
- **Phone:** (585) 474-4589
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Soflo Podiatry LLC (NPI 1780339242, Hollywood, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 1, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1205398724) · Data from the CMS NPPES public registry.