ROTH BUN EA – Foot & Ankle Surgery Podiatrist, NPI 1467984096

ROTH BUN EA is a healthcare provider. based in Downers grove, Illinois. specializing in PODIATRY. They hold a License No. E5893 (CA). The NPI Number for ROTH BUN EA is 1467984096

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
ROTH BUN EA
NPI
1467984096
Phone
(219) 836-0296
Address
555 31ST ST
Enumeration Date
2 April 2017
Last Update Date
2 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9169223668
Graduation Year
2017 (9 years ago)
PAC ID
6709157712
Group Practice PAC ID
3577894682
Professional Enrollment ID
I20220930001749
Address ID
CA958256524SA500XXAVEX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

141 PODIATRY in NM

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Provider Addresses for ROTH BUN EA

  • 31st Street, Downers Grove, DuPage County, Illinois, 60515, United States

    DOWNERS GROVE, IL 605151235

    Phone: (219) 836-0296

    Type: Mailing

  • Galisteo Street, Santa Fe, Santa Fe County, New Mexico, 87504-5102, United States

    SANTA FE, NM 875052143

    Phone: (505) 395-9575

    Fax: (877) 540-1253

    Type: Location

  • 635 ANDERSON RD STE 19

    DAVIS, CA 956163505

    Phone: (530) 758-1810

    Fax: (530) 758-1896

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $1,372.

Total Amount is formed as General ($1,372) + Research ($0) + Ownership ($0) = $1,372.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Stryker Corporation ($526).

Total Amount

$1,372

General + Research + Ownership

Payments

24

Total payment records

General Amount

$1,372

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

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: 2022-09-30

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
I20220930001749IPodiatryCATBD

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 minutes444241$0
11721Removal of fingernails or toenails, 6 or more nails203101$0
99203New patient office or other outpatient visit, 30-44 minutes165165$0
99214Established patient office or other outpatient visit, 30-39 minutes11457$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes7533$0
View full utilization report →

Insurance plans in this area (ZIP 60515)

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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: 3577894682View full group profile
NameSpecialtyState
P O D I A T R YCA
P O D I A T R YMA
P O D I A T R YCA
P O D I A T R YWI

Reviews

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Frequently asked questions

Can I cross-check ROTH BUN EA using NPI 1467984096?
NPI 1467984096 belongs to ROTH BUN EA; compare other details if you need extra assurance.
Is ROTH BUN EA still an active registrant?
ROTH BUN EA carries an active NPI according to the public dataset.
What expertise is attributed to ROTH BUN EA?
ROTH BUN EA's specialty line reads Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ROTH BUN EA?
Travel planning: use Downers Grove, Illinois as the reference point for ROTH BUN EA, then confirm.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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