Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Jacob Roth, PA-C

Individual provider Physician Assistant · NPI 1649620352

Benjamin Jacob Roth, PA-C is a Physician Assistant in Oak Park, Illinois. Qualified in 2016, 10 years ago. Practices with Rockford Psychiatric Medical Services SC, a 151-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3 Erie Ct
Oak Park, IL 60302-2519
Phone: (708) 763-6747
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.005905 (IL)

Record details

NPI number1649620352
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 14, 2016
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Rockford Psychiatric Medical Services Sc — 151 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Oak Park