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KEVIN M ROTH M.D.
NPI 1679778252
Orthopaedic Surgery - Sports Medicine in Palo Alto, CA

Active since June 15, 2007PECOS EnrolledAccepts Medicare Assignment
795 EL CAMINO REAL, PALO ALTO, CA 94301(650) 853-2951 Get Directions Write a Review

NPPES record last updated: June 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 6, 2023, Nov 12, 2020, May 11, 2017 (3 updates tracked since 2017).

About Kevin M Roth M.d. NPPES

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

KEVIN M ROTH M.D. (NPI 1679778252) is an individual sports medicine provider in Palo Alto, California, licensed in California (A121082) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1679778252
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameKEVIN M ROTHCredential: M.D.
Location Address795 EL CAMINO REALPalo Alto, CA 94301-2302
Mailing Address325 Distel CirLos Altos, CA 94022-1408 · (650) 853-2951
Phone(650) 853-2951
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJune 15, 2007
Last NPPES UpdateJune 6, 20233 updates tracked since enumeration
NPPES CertifiedDecember 9, 2020
✔ NPI 1679778252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in CA · A121082
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License A121082 (CA)
795 EL CAMINO REAL, Palo Alto, CA 94301
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Secondary Practice Locations 2

Location 12625 Shadelands DrWalnut Creek, CA 94598-2512 · Phone (925) 939-8585
Location 23315 BroadwayOakland, CA 94611-5717 · Phone (510) 486-2300 · Fax (510) 486-2333

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

Kevin M Roth M.d. 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 ID941467666
PECOS Enrollment IDI20130722000439
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

3

Medicare enrollment records show Kevin Roth reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sutter Bay Medical Foundation
Same address
Multi-Specialty
795 EL CAMINO REAL
Palo Alto, CA 94301
NPI 1013950807 (650) 321-4121
Golden State Orthopedics & Spine
13 mi
Orthopaedic Surgery
39350 CIVIC CENTER DR STE 300
Fremont, CA 94538
  • Reassigned Medicare billing, California enrollment
  • 211 clinicians in this Medicare group
NPI 1508701095 (510) 797-3933
John Muir Trauma Physicians Billing Service
33 mi
Hospitalist
1601 YGNACIO VALLEY RD
Walnut Creek, CA 94598
  • Reassigned Medicare billing, California enrollment
  • 810 clinicians in this Medicare group
NPI 1093864837 (925) 947-5331

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 9

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
174 services137 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
114 services114 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
102 services75 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
96 services23 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
78 services60 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
44 services24 patients

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. SHIRA BETH LIPTON M.D.
Dermatology
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 853-2982
DR. KATHERINE A KWIATKOWSKI MD
Psychiatry & Neurology (Psychiatry)
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 853-2904
MS. HEATHER HUGHES ROSE PT
Physical Therapist
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (707) 280-2417
CRYSTAL TSAI MS, RD
Dietitian, Registered
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 853-2961
RUTH ROTHMAN MD
Dermatology
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 853-4865
WINONA TAN M.D.
Obstetrics & Gynecology
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 853-2917
SHERRY HUANG MD
Family Medicine
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 853-2984
DR. JULIA MCKENZIE GABHART M.D.
Pediatrics
795 EL CAMINO REAL
PALO ALTO, CA 94301
Santa Clara County (650) 321-4121

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 Kevin Roth's NPI number?

The NPI number for Kevin Roth is 1679778252. It was assigned to this individual provider in the NPPES registry on June 15, 2007.

Where is Kevin Roth located?

Kevin Roth practices at 795 El Camino Real, Palo Alto, CA 94301. The listed phone number is (650) 853-2951.

What is Kevin Roth's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Kevin Roth enrolled in Medicare?

Yes. Kevin 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 Kevin Roth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Roth reassigns Medicare benefits to 3 organizations: Sutter Bay Medical Foundation (Palo Alto, CA), Golden State Orthopedics & Spine (Fremont, CA) and John Muir Trauma Physicians Billing Service (Walnut Creek, CA). 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 Kevin 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 Kevin Roth was last updated on June 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.