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KARLA JEAN ROTH MD
NPI 1508890971
Family Medicine in De Pere, WI

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
3860 MONROE RD, DE PERE, WI 54115(920) 496-4700(920) 431-1967 Get Directions Write a Review

NPPES record last updated: September 24, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 24, 2019, Sep 20, 2019 (2 updates tracked since 2019).

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 Nicholas Hospital, and is a graduate of University Of Wisconsin School Of Medicine (1992).

NPPES Registry Identity

NPI1508890971
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKARLA JEAN ROTHCredential: MD
Location Address3860 MONROE RDDe Pere, WI 54115-8399
Mailing Address3860 Monroe RdDe Pere, WI 54115-8399 · (920) 496-4700
Phone(920) 496-4700
Fax(920) 431-1967
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1992
Enumeration DateJuly 10, 2006
Last NPPES UpdateSeptember 24, 20192 updates tracked since enumeration
✔ NPI 1508890971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 37108
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3860 MONROE RD, De Pere, WI 54115
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Other Identifiers 1

Medicaid32183200WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID8022006097
PECOS Enrollment IDI20040506000438
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.

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.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
182 services78 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
121 services73 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
53 services52 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
42 services42 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
31 services25 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
26 services26 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520044
Location3100 Superior AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

Hshs St Clare Memorial Hospital

Critical Access Hospitals · Oconto Falls, WI
OwnershipVoluntary non-profit - Private
CMS Certification Number521310
Location855 S Main StOconto Falls, WI 54154 · Oconto County
Emergency services

Physician 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.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

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.

CASSANDRA VANSTRATEN LPC
Counselor (Mental Health)
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
ROSALYN H HAASE RD CD
Dietitian, Registered
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
DANIELLE CASPER
Marriage & Family Therapist
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
MARIE D. IBARRA STAFFORD LPC
Counselor (Mental Health)
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
DR. JOSHUA VINCENT EGLE PT, DPT
Physical Therapist
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
MR. DAN J BRAATEN LMFT, SAC
Marriage & Family Therapist
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
STEPHANIE PREVOST M.S.
Counselor (Professional)
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
ALEKSANDRA BABIARZ MD
Family Medicine
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700

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.

What insurance does Karla Roth accept?

Health plans from Anthem Blue Cross and Blue Shield list Karla Roth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Karla Roth affiliated with any hospitals?

According to CMS data, Karla Roth is affiliated with St Nicholas Hospital, St Vincent Hospital and Hshs St Clare Memorial Hospital.

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 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.