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

Douglas A Roth, MD

Individual provider Plastic Surgery Physician · NPI 1205873924

Douglas A Roth, MD is a Plastic and Reconstructive Surgery in Mount Kisco, New York. Graduated from New York University School of Medicine in 1990, 36 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
36
Trained at
New York University School of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

90 S Bedford Rd Mount Kisco Medical Group Pc
Mount Kisco, NY 10549-3412
Phone: (914) 241-1050
Fax: (914) 242-2909
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence 186557 (NY)

Record details

NPI number1205873924
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 1, 2006
Last updated in NPPESJuly 22, 2016
Mailing address110 S Bedford Rd, Mount Kisco Medical Group, Pc, Mount Kisco, NY 10549-3446

Medicare enrollment

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

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Also practisesGENERAL SURGERY
Medical schoolNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduated 1990 (36 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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