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SU ROTH
NPI 1265023642
Social Worker - Clinical in Fort Wayne, IN

Active since January 28, 2021PECOS Enrolled
8633 CASTLE CREEK DR, FORT WAYNE, IN 46804(317) 775-4994 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2026, Jan 28, 2021 (2 updates tracked since 2021).

About Su Roth NPPES

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

SU ROTH (NPI 1265023642) is an individual clinical provider in Fort Wayne, Indiana, licensed in Indiana (34010888A) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265023642
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSU ROTH
Location Address8633 CASTLE CREEK DRFort Wayne, IN 46804-2759
Mailing Address8633 Castle Creek DrFort Wayne, IN 46804-2759 · (317) 775-4994
Phone(317) 775-4994
Sole ProprietorNo
Enumeration DateJanuary 28, 2021
Last NPPES UpdateMay 5, 20262 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1265023642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IN · 34010888A
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
8633 CASTLE CREEK DR, Fort Wayne, IN 46804
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 (PECOS)

Su Roth is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46804 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
$0.00 typical visit price
range $53.07 – $161.76
Typical copayment $0.00 (range $13.26 – $40.44)
Most-billed visit code NA
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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.

Other Providers at the Same Location NPPES

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

HARMONY WITHIN LLC
Social Worker (Clinical)
8633 CASTLE CREEK DR
FORT WAYNE, IN 46804
Allen County (317) 775-4994

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 Su Roth's NPI number?

The NPI number for Su Roth is 1265023642. It was assigned to this individual provider in the NPPES registry on January 28, 2021.

Where is Su Roth located?

Su Roth practices at 8633 Castle Creek Dr, Fort Wayne, IN 46804. The listed phone number is (317) 775-4994.

What is Su Roth's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Su Roth enrolled in Medicare?

Yes. Su Roth is registered in the Medicare PECOS enrollment system.

What insurance does Su Roth accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and UnitedHealthcare list Su 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.

When was this NPI record last updated?

The NPPES record for Su Roth was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.