Look up the most recent NPI and PECOS records

Andrea Roth

Social Worker

Behavioral Health & Social Service Providers

109 W 27th St Ste 5s, New York, NY 10001-0265

PECOS Enrollment

Based on the most recent information from CMS, provider Andrea Roth is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 2:56 PM.

Profile Details

Provider ID
1568945301
Provider Type
Individual
Full Name
Roth, Andrea
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/7/2018
Last Updated
10/29/2024

Contact Information

Practice Location

109 W 27th St Ste 5s, New York, NY 10001-0265

(833) 351-8255

Unlisted Fax

Mailing Location

PO Box 24449, New York, NY 10087-0589

(833) 351-8255

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 093829 New York
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License I.2405984 Ohio
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 9438 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 1336163963	Description Medicaid	Issuer Unlisted New York

Andrea Roth

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

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License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Handler, Jennifer

Selvarajah, Sibi

Millstein, Ezra William

Hoffman, Amy Karen

Wu, Winifred Y

The Institute For Family Health

Hassan, Sara

Hartung, Priscilla L

Garrison, Barry

Schur, Ariel