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DR. BRANDON IAN ROTH M.D. NPI 1568849990


NPI Information

NPI: 1568849990
Provider Name: DR. BRANDON IAN ROTH, M.D.
Classification: Pain Medicine - 208VP0014X
Entity Type: Individual

Specialization: Interventional Pain Medicine

Organization: ARIZONA PAIN SPECIALISTS PLLC

PECOS Registration: Yes

Address:
18555 N 79TH AVE STE D101
GLENDALE, AZ
ZIP 85308
Phone: (480) 563-6400
Get Directions

DR. Brandon Ian Roth, M.D. is an interventional pain medicine pain medicine in Glendale, AZ with 9 years of experience. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. DR. Brandon Ian Roth, M.D. NPI is 1568849990. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

18555 N 79TH AVE STE D101
GLENDALE, AZ
ZIP 85308-040
Phone: (480) 563-6400
Fax: (480) 563-8009

The NPI 1568849990 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/6/2015 and was last updated on 4/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207L00000XAnesthesiology60636ARIZONANo
2208VP0014XPain MedicineInterventional Pain Medicine60636ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1007126MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.