DOUGLAS A ROTH MD
NPI 1205873924
Plastic Surgery in Mount Kisco, NY
About Douglas A Roth Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DOUGLAS A ROTH MD (NPI 1205873924) is an individual plastic surgery provider in Mount Kisco, New York, licensed in New York (186557) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of New York University School Of Medicine (1990).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
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
Douglas A Roth Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show Douglas Roth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mount Kisco, NY 10549
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Optum Medical Care PC
- 1,601 clinicians in this Medicare group
Great Neck, NY 11021
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10549 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MOUNT KISCO, NY 10549
MOUNT KISCO, NY 10549
MOUNT KISCO, NY 10549
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 Douglas Roth's NPI number?
The NPI number for Douglas Roth is 1205873924. It was assigned to this individual provider in the NPPES registry on June 1, 2006.
Where is Douglas Roth located?
Douglas Roth practices at 90 S Bedford Rd Mount Kisco Medical Group, PC, Mount Kisco, NY 10549. The listed phone number is (914) 241-1050.
What is Douglas Roth's specialty?
The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.
Is Douglas Roth enrolled in Medicare?
Yes. Douglas 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.
Which organizations bill Medicare for Douglas Roth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Roth reassigns Medicare benefits to 2 organizations: Optum Medical Care, P.C. (Mount Kisco, NY) and North Shore-Lij Medical PC (Great Neck, NY). Each 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 Douglas 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 Douglas Roth was last updated on July 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Douglas A Roth, MD · NPI 1205873924
Plastic Surgery physician in Mount Kisco, New York. Individual provider, active in the CMS NPPES registry since June 1, 2006.
## Identity
- **NPI:** 1205873924 (Entity type: Individual)
- **Enumerated:** June 1, 2006
- **Primary specialty:** Plastic Surgery · taxonomy 208200000X
- **State license:** 186557 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 90 S BEDFORD RD, MOUNT KISCO MEDICAL GROUP, PC, Mount Kisco, NY 10549-3412
- **Phone:** (914) 241-1050 · **Fax:** (914) 242-2909
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Optum Medical Care, P.C. (NPI 1982643003, Mount Kisco, NY); North Shore-Lij Medical PC (NPI 1053688572, Great Neck, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York University School Of Medicine, class of 1990
## Record status
- **NPPES last updated:** July 22, 2016
- **Other identifiers:** Medicare UPIN G89601 (NY); Medicare PIN 38L9406761 (NY); Medicaid 01921351 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1205873924) · Data from the CMS NPPES public registry.