JEFFREY IRA ROTH (MD) – Otolaryngology Physician, NPI 1417945320

JEFFREY IRA ROTH (MD) is a healthcare provider. based in Suwanee, Georgia. specializing in OTOLARYNGOLOGY. They hold the professional credentials MD. They hold a License No. 041654 (GA). The NPI Number for JEFFREY IRA ROTH (MD) is 1417945320

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY IRA ROTH (MD)
NPI
1417945320
Phone
(770) 623-1608
Address
4385 JOHNS CREEK PKWY
Enumeration Date
13 October 2005
Last Update Date
18 December 2009

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Secondary Phone
7706231608
Graduation Year
1991 (35 years ago)
PAC ID
8820018088
Group Practice PAC ID
7012979636
Professional Enrollment ID
I20110120000774
Address ID
GA300246674SU3915XCTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

392 OTOLARYNGOLOGY in GA

Provider Addresses for JEFFREY IRA ROTH (MD)

  • 4385 JOHNS CREEK PKWY

    STE 250

    SUWANEE, GA 300246048

    Phone: (770) 623-1608

    Fax: (678) 992-2540

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 47 Open Payments records for all available years, with a total value of $1,765.

Total Amount is formed as General ($1,765) + Research ($0) + Ownership ($0) = $1,765.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: AERIN MEDICAL INC. ($499).

Total Amount

$1,765

General + Research + Ownership

Payments

47

Total payment records

General Amount

$1,765

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110120000774IOtolaryngologyGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes315250$0
99214Established patient office or other outpatient visit, 30-39 minutes201162$0
99203New patient office or other outpatient visit, 30-44 minutes166166$0
31231Diagnostic exam of nasal passages using an endoscope137114$0
31575Diagnostic exam of voice box using a flexible endoscope7467$0
View full utilization report →

Insurance plans in this area (ZIP 30024)

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Provider's Procedures

JEFFREY IRA ROTH (MD) performs procedures in OTOLARYNGOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OTOLARYNGOLOGYGA92567Eardrum testing using ear probe1717

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012979636View full group profile
NameSpecialtyState
Qualified AudiologistGA
Qualified AudiologistGA
O T O L A R Y N G O L O G YGA
Allergy/Immunology, Diagnostic Radiology, OtolaryngologyGA
Otolaryngology, Diagnostic Radiology, Allergy/ImmunologyPA
Qualified AudiologistGA
Qualified AudiologistGA
Allergy/Immunology, Otolaryngology, Diagnostic RadiologyGA
Qualified AudiologistGA
Qualified AudiologistGA

Reviews

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Frequently asked questions

What is the registry number for JEFFREY IRA ROTH (MD)?
The registry entry for JEFFREY IRA ROTH (MD) shows NPI 1417945320.
Is JEFFREY IRA ROTH (MD) currently accepting referrals based on NPI status?
Registry metadata lists JEFFREY IRA ROTH (MD) as active.
What type of care does JEFFREY IRA ROTH (MD) provide?
JEFFREY IRA ROTH (MD)'s profile centers on Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JEFFREY IRA ROTH (MD)?
JEFFREY IRA ROTH (MD) is associated with Suwanee, Georgia in the same public data insurers reference.
Why is information missing for JEFFREY IRA ROTH (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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