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JONATHAN ROTH
NPI 1366565913
Counselor - Mental Health in Ithaca, NY

Active since April 09, 2007PECOS Enrolled
122 W COURT ST, ITHACA, NY 14850(607) 275-5965 Get Directions Write a Review

NPPES record last updated: September 4, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jonathan Roth NPPES

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

JONATHAN ROTH (NPI 1366565913) is an individual mental health provider in Ithaca, New York, licensed in New York (005266) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in San Francisco.

NPPES Registry Identity

NPI1366565913
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJONATHAN ROTH
Location Address122 W COURT STIthaca, NY 14850
Mailing AddressPo Box 6632Ithaca, NY 14851-6632 · (415) 564-5117
Phone(607) 275-5965
Sole ProprietorYes
Enumeration DateApril 9, 2007
Last NPPES UpdateSeptember 4, 2018
✔ NPI 1366565913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 005266
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 86401 (CA)
122 W COURT ST, Ithaca, NY 14850
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Secondary Practice Location 1

Location 1815 Hyde StSan Francisco, CA 94109-5996 · Phone (415) 673-5700 · Fax (415) 292-7140

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan 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.

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.

MS. CATHERINE JANE HALLIDAY LCSW
Social Worker (Clinical)
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 279-5439
TAMARA L LOOMIS LCSW
Social Worker (Clinical)
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 275-3675
COURT ST. CHIROPRACTIC OF ITHACA, P.C.
Chiropractor
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 273-7682
MARY LOU CARLUCCI MPSPT
Physical Therapist
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 591-1591
MS. SHEILA MCCUE LCSW
Social Worker (Clinical)
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 227-0313
LAUREN BURCH LMSW
Social Worker
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 256-4422
MS. LESLIE SHAKESPEARE LCSW
Social Worker (Clinical)
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 256-4422
MRS. MELISSA RADHAY LMFT
Marriage & Family Therapist
122 W COURT ST
ITHACA, NY 14850
Tompkins County (607) 319-2980

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 Jonathan Roth's NPI number?

The NPI number for Jonathan Roth is 1366565913. It was assigned to this individual provider in the NPPES registry on April 9, 2007.

Where is Jonathan Roth located?

Jonathan Roth practices at 122 W Court St, Ithaca, NY 14850. The listed phone number is (607) 275-5965.

What is Jonathan Roth's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jonathan Roth enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jonathan Roth was last updated on September 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.