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CAROLYN ROTH N.P.
NPI 1679609630
Nurse Practitioner in Bloomington, IL

Active since February 26, 2007PECOS Enrolled
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704(309) 664-3038 Get Directions Write a Review

NPPES record last updated: November 20, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carolyn Roth N.p. NPPES

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

CAROLYN ROTH N.P. (NPI 1679609630) is an individual nurse practitioner in Bloomington, Illinois, licensed in Illinois (209000155) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679609630
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCAROLYN ROTHCredential: N.P.
Location Address1701 E COLLEGE AVEBloomington, IL 61704-2101
Mailing Address1701 E College AveBloomington, IL 61704-2101 · (309) 664-3000
Phone(309) 664-3038
Sole ProprietorNo
Enumeration DateFebruary 26, 2007
Last NPPES UpdateNovember 20, 2009
✔ NPI 1679609630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209000155
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1701 E COLLEGE AVE, Bloomington, IL 61704
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Other Identifiers 4

OtherIL2613IL · Medicare Group Ptan
Medicare PINIL2613030IL
Medicare UPINR17521IL
Medicare NSC0533210001IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolyn Roth N.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61704 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

MS. MARY CLAIRE BILES PT, MDT
Physical Therapist
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 664-3420
CAREY HARRIS NP
Nurse Practitioner
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 664-3120
ST. JOSEPH MEDICAL CENTER
Hospice Care, Community Based
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 451-5925
MRS. PATRICIA O'MEARA MPT, NDT
Physical Therapist
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 664-3420
PAUL PEDERSEN
Internal Medicine
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 664-3120
MS. GRETCHEN DEAN PT
Physical Therapist
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (217) 326-2911
CHRISTOPHER RINK D.O.
Physical Medicine & Rehabilitation (Pain Medicine)
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 661-6250
MRS. CECILIA SIBERON-SONE ARNP
Nurse Practitioner
1701 E COLLEGE AVE
BLOOMINGTON, IL 61704
McLean County (309) 665-4729

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 Carolyn Roth's NPI number?

The NPI number for Carolyn Roth is 1679609630. It was assigned to this individual provider in the NPPES registry on February 26, 2007.

Where is Carolyn Roth located?

Carolyn Roth practices at 1701 E College Ave, Bloomington, IL 61704. The listed phone number is (309) 664-3038.

What is Carolyn Roth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Carolyn Roth enrolled in Medicare?

Yes. Carolyn Roth is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carolyn Roth was last updated on November 20, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.