DR. MARY ELLEN ROTH O.D.
NPI 1912065160
Optometrist in Canton, OH

Q: What is Mary Roth's NPI number?

The NPI number for Mary Roth is 1912065160. It was assigned to this individual provider in the NPPES registry on December 4, 2006.

Q: What is Mary Roth's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Roth was last updated on January 24, 2020. 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.

Active since December 04, 2006PECOS Enrolled

4157 BELDEN VILLAGE MALL, CANTON, OH 44718(330) 494-4140(866) 425-2239 Get Directions Write a Review

NPPES record last updated: January 24, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Mary Ellen Roth O.d. NPPES

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

DR. MARY ELLEN ROTH O.D. (NPI 1912065160) is an individual optometrist in Canton, Ohio, licensed in Ohio (3777) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Ohio State University - College Of Optometry (1985).

NPPES Registry Identity

NPI1912065160

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. MARY ELLEN ROTHCredential: O.D.

Location Address4157 BELDEN VILLAGE MALLCanton, OH 44718-2501

Mailing AddressPo Box 880Hudson, OH 44236-5880 · (330) 697-4748 · Fax (866) 425-2239

Phone(330) 494-4140

Fax(866) 425-2239

Sole ProprietorNo

Medical School CMSOhio State University - College Of OptometryGraduated 1985

Enumeration DateDecember 4, 2006

Last NPPES UpdateJanuary 24, 2020

✔ NPI 1912065160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in OH · 3777

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 3777 (OH)

4157 BELDEN VILLAGE MALL, Canton, OH 44718

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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)

Dr. Mary Ellen Roth O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264474717

PECOS Enrollment IDI20050525000723

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

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

Belden Optometry LLC

Same address

Optometrist

4157 BELDEN VILLAGE MALL
Canton, OH 44718

Reassigned Medicare billing, Ohio enrollment
6 clinicians in this Medicare group

NPI 1972049716 (330) 494-4140

Dr. Richard E. Hults & Assoc., Inc.

Same address

Optometrist

4157 BELDEN VILLAGE MALL
Canton, OH 44718

Reassigned Medicare billing, Ohio enrollment
11 clinicians in this Medicare group

NPI 1437372208 (330) 494-4140

Summit Family Vision LLC

21 mi

Optometrist

3265 W MARKET ST
Fairlawn, OH 44333

Reassigned Medicare billing, Ohio enrollment
8 clinicians in this Medicare group

NPI 1962065672 (330) 836-2200

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 2

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 complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

15 services15 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44718 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

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 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LUXOTTICA OF AMERICA INC.

Eyewear Supplier

4157 BELDEN VILLAGE MALL
CANTON, OH 44718

Stark County (330) 494-2222

DR. RICHARD E. HULTS & ASSOC., INC.

Optometrist

4157 BELDEN VILLAGE MALL
CANTON, OH 44718

Stark County (330) 494-4140

DR. ADAM ERNEST SCHMIDT OD

Optometrist

4157 BELDEN VILLAGE MALL
CANTON, OH 44718

Stark County (330) 697-4748

BELDEN OPTOMETRY LLC

Optometrist

4157 BELDEN VILLAGE MALL
CANTON, OH 44718

Stark County (330) 494-4140

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 Mary Roth's NPI number?

The NPI number for Mary Roth is 1912065160. It was assigned to this individual provider in the NPPES registry on December 4, 2006.

Where is Mary Roth located?

Mary Roth practices at 4157 Belden Village Mall, Canton, OH 44718. The listed phone number is (330) 494-4140.

What is Mary Roth's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mary Roth enrolled in Medicare?

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

Which organizations bill Medicare for Mary Roth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Roth reassigns Medicare benefits to 3 organizations: Belden Optometry LLC (Canton, OH), Dr. Richard E. Hults & Assoc., Inc. (Canton, OH) and Summit Family Vision LLC (Fairlawn, OH). 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 Mary Roth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Roth accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and CareSource list Mary 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.

When was this NPI record last updated?

The NPPES record for Mary Roth was last updated on January 24, 2020. 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.