KARLA JEAN ROTH MD
NPI 1508890971
Family Medicine in De Pere, WI
About Karla Jean Roth Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KARLA JEAN ROTH MD (NPI 1508890971) is an individual family medicine provider in De Pere, Wisconsin, licensed in Wisconsin (37108) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of University Of Wisconsin School Of Medicine (1992).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Karla Jean Roth Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
5Medicare enrollment records show Karla Roth reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- 190 clinicians in this Medicare group
Green Bay, WI 54304
- Reassigned Medicare billing, Wisconsin enrollment
- Also billed through NPI 1689694911 (Wisconsin)
- 742 clinicians in this Medicare group
Green Bay, WI 54301
- Reassigned Medicare billing, Wisconsin enrollment
- 216 clinicians in this Medicare group
Green Bay, WI 54303
- Reassigned Medicare billing, Wisconsin enrollment
- 57 clinicians in this Medicare group
Sheboygan, WI 53081
- Reassigned Medicare billing, Wisconsin enrollment
- 673 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.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Vincent Hospital
Acute Care Hospitals · Green Bay, WISt Mary's Hospital Medical Center
Acute Care Hospitals · Green Bay, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Karla Roth's NPI number?
The NPI number for Karla Roth is 1508890971. It was assigned to this individual provider in the NPPES registry on July 10, 2006.
Where is Karla Roth located?
Karla Roth practices at 3860 Monroe Rd, De Pere, WI 54115. The listed phone number is (920) 496-4700.
What is Karla Roth's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Karla Roth enrolled in Medicare?
Yes. Karla Roth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Karla Roth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Karla Roth reassigns Medicare benefits to 5 organizations: Prevea Clinic, Inc. (Green Bay, WI), St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (Green Bay, WI), St. Clare Memorial Hospital, Inc. (Green Bay, WI), St. Mary's Hospital Medical Center Of Green Bay Inc.-Hospital Sisters (Green Bay, WI) and St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (Sheboygan, WI). 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 Karla Roth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Karla Roth affiliated with any hospitals?
According to CMS data, Karla Roth is affiliated with St Vincent Hospital and St Mary's Hospital Medical Center.
When was this NPI record last updated?
The NPPES record for Karla Roth was last updated on September 24, 2019. 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.
# Karla Jean Roth, MD · NPI 1508890971
Family Medicine physician in De Pere, Wisconsin. Individual provider, active in the CMS NPPES registry since July 10, 2006.
## Identity
- **NPI:** 1508890971 (Entity type: Individual)
- **Enumerated:** July 10, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 37108 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 3860 MONROE RD, De Pere, WI 54115-8399
- **Phone:** (920) 496-4700 · **Fax:** (920) 431-1967
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Prevea Clinic, Inc. (NPI 1306869276, Green Bay, WI); St Vincent Hospital-Hospital Sisters-Third Order Of St Francis (NPI 1285613638, Green Bay, WI); St. Clare Memorial Hospital, Inc. (NPI 1093173791, Green Bay, WI); St. Mary's Hospital Medical Center Of Green Bay Inc.-Hospital Sisters (NPI 1598150864, Green Bay, WI); St. Nicholas Hospital-Sisters Of The Third Order Of St Francis (NPI 1275799413, Sheboygan, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Wisconsin School Of Medicine, class of 1992
## Record status
- **NPPES last updated:** September 24, 2019
- **Other identifiers:** Medicaid 32183200 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1508890971) · Data from the CMS NPPES public registry.