PRISCILLA ROTH-WALL PH.D.
NPI 1457386963
Psychologist - Clinical in Farmington, NM
About Priscilla Roth-wall Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRISCILLA ROTH-WALL PH.D. (NPI 1457386963) is an individual clinical provider in Farmington, New Mexico, licensed in New Mexico (PSY1470) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
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 (PECOS)
Priscilla Roth-wall Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Priscilla Roth-wall reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Farmington, NM 87401
- Reassigned Medicare billing, New Mexico enrollment
- 368 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 87401 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FARMINGTON, NM 87401
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 Priscilla Roth-wall's NPI number?
The NPI number for Priscilla Roth-wall is 1457386963. It was assigned to this individual provider in the NPPES registry on July 12, 2006.
Where is Priscilla Roth-wall located?
Priscilla Roth-wall practices at 3751 N Butler Ave Ste 115, Farmington, NM 87401. The listed phone number is (505) 787-2640.
What is Priscilla Roth-wall's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Priscilla Roth-wall enrolled in Medicare?
Yes. Priscilla Roth-wall is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Priscilla Roth-wall's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Priscilla Roth-wall reassigns Medicare benefits to San Juan Regional Medical Center Inc (Farmington, NM). 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 Priscilla Roth-wall'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 Priscilla Roth-wall was last updated on April 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Priscilla Roth-Wall, PH.D. · NPI 1457386963
Clinical provider in Farmington, New Mexico. Individual provider, active in the CMS NPPES registry since July 12, 2006.
## Identity
- **NPI:** 1457386963 (Entity type: Individual)
- **Enumerated:** July 12, 2006
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY1470 (New Mexico)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3751 N BUTLER AVE STE 115, Farmington, NM 87401-6425
- **Phone:** (505) 787-2640 · **Fax:** (505) 787-2789
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** San Juan Regional Medical Center Inc (NPI 1255285490, Farmington, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 30, 2020
- **Other identifiers:** Medicaid 16970748 (NM); Other 73763700 (NM); Other PSY1470 (NM)
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Source: [NPI Profile](https://npiprofile.com/npi/1457386963) · Data from the CMS NPPES public registry.