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Deactivated NPI 1538252630 Deactivated / Inactive NPI Male Practitioner

Dr. Charles A Roth , MD

Specialist • Gulf Breeze, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Charles Roth has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 02, 2006
NPI Deactivation Date February 28, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Charles Roth, MD was a registered Specialist practicing in Gulf Breeze, FL. Throughout an active medical career spanning 14 years, Dr. Roth provided care at the practice location at 1040 GULF BREEZE PKWY until profile deactivation on 2020-02-28.

Historical Medicare Part B clinical services included established patient outpatient office visit, x-ray of shoulder, minimum of 2 views, new patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1040 Gulf Breeze Pkwy
Suite 200

Gulf Breeze, FL 325617809

Telephone 8509163700
Fax 8509163710
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Gulf Breeze, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 37.8 Yrs
Regional Practice Density
3 Specialists

Practicing in Gulf Breeze, FL (3036 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
57.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
68 62 $148.68 $72.05
73030 X-ray of shoulder, minimum of 2 views
32 28 $20.00 $11.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
31 31 $220.00 $104.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
30 29 $220.00 $103.31
20610 Aspiration and/or injection of fluid from large joint
29 29 $118.62 $66.16
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg
28 14 $15.00 $1.12
73562 X-ray of knee, 3 views
25 24 $20.00 $11.90
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
25 25 $15.00 $6.79
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
17 17 $326.76 $153.18
73564 X-ray of knee, 4 or more views
16 16 $25.00 $13.48
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope
16 16 $375.00 $173.29
29827 Repair of shoulder rotator cuff using an endoscope
14 14 $2200.00 $1068.87
29823 Removal of extensive shoulder joint tissue using an endoscope
11 11 $1280.00 $327.23

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License FL ME46571

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

35 Associated Practitioners
Dr. Matthew Mai , MD

Orthopaedic Surgery

NPI 1003902354

Doctor of Medicine (M.D.)

Dr. Daniel Murawski , MD

Orthopaedic Surgery - Foot and Ankle Surgery

NPI 1033121140

Doctor of Medicine (M.D.)

Richard Nenstiel , PA-C

Physician Assistant - Surgical

NPI 1053313312

Physician Assistant (Certified)

Jennifer Lynch Riggs , PA

Physician Assistant

NPI 1053486118

Physician Assistant

Christopher Burpo , PT

Physical Therapist

NPI 1144184276

Physical Therapist

Dr. David Chandler , MD

Orthopaedic Surgery

NPI 1144224122

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 28, 2020

Record deactivated on February 28, 2020

NPI Profile Active November 29, 2011

NPI status registered as active in NPPES database

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Updated Practice Location November 29, 2011

Registered at 1040 GULF BREEZE PKWY, SUITE 200, GULF BREEZE, FL 325617809 (Tel: 8509163700)

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Updated Business Mailing Address November 29, 2011

Registered at PO BOX 30532, PENSACOLA, FL 325031532 (Tel: 8509163700)

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Provider Name / Credentials Updated November 29, 2011

Recorded as CHARLES ROTH, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 29, 2011

Specialist (License #ME46571 in FL)

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Initial NPI Registration & Enumeration October 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1538252630
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 02, 2006
Last Update: November 29, 2011
Deactivation Date: February 28, 2020

Mailing Address

Po Box 30532

Pensacola, FL 325031532

Phone: 8509163700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.