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, billing reassignment, and ordering and referring status from CMS.
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).
Medicare Billing Reassignments
4Medicare enrollment records show Daniel Roth reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Farmington, CT 06032
- Reassigned Medicare billing, Connecticut enrollment
- 496 clinicians in this Medicare group
Reading, PA 19601
- Reassigned Medicare billing, Pennsylvania enrollment
- 399 clinicians in this Medicare group
Savannah, GA 31404
- Reassigned Medicare billing, Georgia enrollment
- 104 clinicians in this Medicare group
Columbus, GA 31901
- Reassigned Medicare billing, Georgia enrollment
- 391 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.
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.
Which organizations bill Medicare for Daniel Roth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Roth reassigns Medicare benefits to 4 organizations: Prohealth Physicians PC (Farmington, CT), Reading Hospital (Reading, PA), Mppg, Inc. (Savannah, GA) and Columbus Ambulatory Healthcare Services, Inc. (Columbus, GA). 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 Daniel 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 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 17 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
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Prohealth Physicians PC (NPI 1720194053, Farmington, CT); Reading Hospital (NPI 1386702413, Reading, PA); Mppg, Inc. (NPI 1033131172, Savannah, GA); Columbus Ambulatory Healthcare Services, Inc. (NPI 1790733244, Columbus, GA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 8, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1467541078) · Data from the CMS NPPES public registry.