DR. DANIEL JAY ROTH M.D.
NPI 1467541078
Pediatrics - Adolescent Medicine in South Windsor, CT
About Dr. Daniel Jay Roth M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DANIEL JAY ROTH M.D. (NPI 1467541078) is an individual adolescent medicine provider in South Windsor, Connecticut, licensed in Connecticut (81112) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Atlanta.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Daniel Jay Roth M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH WINDSOR, CT 06074
SOUTH WINDSOR, CT 06074
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 Daniel Roth's NPI number?
The NPI number for Daniel Roth is 1467541078. It was assigned to this individual provider in the NPPES registry on October 12, 2006.
Where is Daniel Roth located?
Daniel Roth practices at 1665 Ellington Rd, South Windsor, CT 06074. The listed phone number is (860) 648-2447.
What is Daniel Roth's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.
Is Daniel Roth enrolled in Medicare?
Yes. Daniel Roth is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Daniel Roth was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Dr. Daniel Jay Roth, M.D. · NPI 1467541078
Adolescent Medicine physician in South Windsor, Connecticut. Individual provider, active in the CMS NPPES registry since October 12, 2006.
## Identity
- **NPI:** 1467541078 (Entity type: Individual)
- **Enumerated:** October 12, 2006
- **Primary specialty:** Pediatrics - Adolescent Medicine · taxonomy 2080A0000X
- **State license:** 81112 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 1665 ELLINGTON RD, South Windsor, CT 06074-2778
- **Phone:** (860) 648-2447
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** May 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1467541078) · Data from the CMS NPPES public registry.