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ANDREA LANAO ROTH-ROFFY DO
NPI 1548618614
Pediatrics in Riverton, UT

Active since May 31, 2016PECOS Enrolled
12391 S 4000 W, RIVERTON, UT 84096(801) 302-1700 Get Directions Write a Review

NPPES record last updated: January 19, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 19, 2026, Jan 8, 2026, Jun 2, 2025 (3 updates tracked since 2025).

About Andrea Lanao Roth-roffy Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA LANAO ROTH-ROFFY DO (NPI 1548618614) is an individual pediatrics provider in Riverton, Utah, licensed in Florida (UO4892) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Fayetteville, and is a graduate of Edward Via Col Of Osteo Medicine-carolinas Campus (2016).

NPPES Registry Identity

NPI1548618614
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameANDREA LANAO ROTH-ROFFYCredential: DO
Location Address12391 S 4000 WRiverton, UT 84096-7012
Mailing Address2965 W 3500 SWest Valley City, UT 84119-3602 · (801) 965-3600
Phone(801) 302-1700
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-carolinas CampusGraduated 2016
Enumeration DateMay 31, 2016
Last NPPES UpdateJanuary 19, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 19, 2026
✔ NPI 1548618614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in FL · UO4892✔ Licensed in UT · 14260272-1204
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
12391 S 4000 W, Riverton, UT 84096
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Secondary Practice Location 1

Location 11327 Robeson StFayetteville, NC 28305-5531 · Phone (104) 865-4379

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Cigna Healthcare, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea Lanao Roth-roffy Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1759869183
PECOS Enrollment IDI20260128001526
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Andrea Lanao Roth-roffy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Granger Medical Clinic, PC
0.5 mi
Family Medicine
1288 W 12700 S
Riverton, UT 84065
  • Reassigned Medicare billing, Utah enrollment
  • 190 clinicians in this Medicare group
NPI 1649541699 (801) 253-3500
Granger Medical Specialists LLC
12 mi
Clinic/Center
2965 W 3500 S
West Valley City, UT 84119
  • Reassigned Medicare billing, Utah enrollment
  • 188 clinicians in this Medicare group
NPI 1376159368 (801) 965-3600

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 84096 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

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.

DR. MONICA CHILD WONNACOTT M.D.
Pediatrics
12391 S 4000 W
RIVERTON, UT 84096
Salt Lake County (801) 302-1700
CHRISTOPHER J. JOLLES MD, PC
Specialist
12391 S 4000 W, STE 208
RIVERTON, UT 84096
Salt Lake County (801) 302-5360
APEX FAMILY & COSMETIC DENTISTRY
Dentist (General Practice)
12391 S 4000 W, SUITE 206
RIVERTON, UT 84096
Salt Lake County (801) 748-0379
MR. ADAM CODY CHRISTIANSEN PA-C
Physician Assistant
12391 S 4000 W
RIVERTON, UT 84096
Salt Lake County (801) 302-1700
MR. BRAD ROBERT PULSIPHER MSN-FNP
Nurse Practitioner (Primary Care)
12391 S 4000 W
RIVERTON, UT 84096
Salt Lake County (801) 302-1700
AUBREY ROCHELLE GEORGE FNP-C
Nurse Practitioner (Family)
12391 S 4000 W
RIVERTON, UT 84096
Salt Lake County (801) 302-1700
GRANGER MEDICAL SPECIALISTS LLC
Clinic/Center (Multi-Specialty)
12391 S 4000 W
RIVERTON, UT 84096
Salt Lake County (801) 302-1700
GARRETT KORDSIEMON PA-C
Physician Assistant (Medical)
12391 S 4000 W
RIVERTON, UT 84096
Salt Lake County (801) 965-3600

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 Andrea Lanao Roth-roffy's NPI number?

The NPI number for Andrea Lanao Roth-roffy is 1548618614. It was assigned to this individual provider in the NPPES registry on May 31, 2016.

Where is Andrea Lanao Roth-roffy located?

Andrea Lanao Roth-roffy practices at 12391 S 4000 W, Riverton, UT 84096. The listed phone number is (801) 302-1700.

What is Andrea Lanao Roth-roffy's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Andrea Lanao Roth-roffy enrolled in Medicare?

Yes. Andrea Lanao Roth-roffy is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Andrea Lanao Roth-roffy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Lanao Roth-roffy reassigns Medicare benefits to 2 organizations: Granger Medical Clinic, PC (Riverton, UT) and Granger Medical Specialists LLC (West Valley City, UT). 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 Andrea Lanao Roth-roffy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrea Lanao Roth-roffy accept?

Health plans from BridgeSpan Health Company, Cigna Healthcare, Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health and 1 other insurer list Andrea Lanao Roth-roffy 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.

When was this NPI record last updated?

The NPPES record for Andrea Lanao Roth-roffy was last updated on January 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.