ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) – Physical Therapist, NPI 1164705059

ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) is a healthcare provider. based in Cleveland, Ohio. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT, OCS, SCS, ATC. They hold a License No. 016194 (OH). The NPI Number for ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) is 1164705059

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC)
NPI
1164705059
Phone
(617) 680-2195
Address
1220 WINSTON RD
Enumeration Date
27 September 2011
Last Update Date
15 February 2024

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5633220971
Graduation Year
2011 (15 years ago)
PAC ID
2668646845
Group Practice PAC ID
6406741784
Professional Enrollment ID
I20240419001621
Address ID
IA528061861DA6101XBLVD300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:14State licenses:1Digital endpointsOther names

2,243 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

Provider Addresses for ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC)

  • 1220 WINSTON RD

    CLEVELAND, OH 441212542

    Phone: (617) 680-2195

    Fax: (440) 516-5197

    Type: Mailing

  • 4501 BIRCHWOLD RD

    CLEVELAND, OH 441214217

    Phone: (617) 680-2195

    Fax: (440) 516-5197

    Type: Mailing

  • 29017 CHARDON RD

    WILLOUGHBY HILLS, OH 440921475

    Phone: (440) 516-5414

    Fax: (440) 516-5197

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-04-19

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
I20240419001621IPhysical Therapist In Private PracticeIATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44121)

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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: 6406741784View full group profile
NameSpecialtyState
-MI
Orthopedic SurgeryIA
-SC
Physical Therapist In Private PracticeIA
-IA
Orthopedic SurgeryIL
Physical Therapist In Private PracticeIA
Orthopedic SurgeryIA
Physician AssistantIA
Orthopedic SurgeryIL

Reviews

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Frequently asked questions

Can I use this page to confirm ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC)'s NPI?
Yes. ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) is listed with NPI 1164705059 in the public NPI dataset.
Does the file indicate ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) is practicing under active NPI?
Directory data currently reports ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) as active.
What taxonomy line describes ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC)?
For research purposes, treat ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where is ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) based?
ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) is tied to Cleveland, Ohio in the data we show; additional addresses may exist on the full record.
Is the information about ANDREW JEREMIAH ROTH (DPT, OCS, SCS, ATC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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