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

Dr. Justin Stephan Roth, DO

Individual provider Pediatric Orthopaedic Surgery Physician · NPI 1306109954

Dr. Justin Stephan Roth, DO is an Orthopedic Surgery in Meridian, Idaho. Qualified in 2012, 14 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho and Oregon.

Years since qualifying
14
Licensed in
ID, OR
In the registry since
2012
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

3399 E Louise Dr Ste 200
Meridian, ID 83642-5212
Phone: (208) 706-2663
Show map & directions

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

Additional practice locations (2)

  • 4625 Lindell Blvd, Suite 420, St. Louis, MO 63108-3927 — (314) 747-2555
  • 2200 Ne Neff Rd Ste 200, Bend, OR 97701-4281 — (541) 382-3344

Specialties & licences

Pediatric Orthopaedic Surgery Physician (primary) Taxonomy 207XP3100X · Licence O-1847 (ID)
Pediatric Orthopaedic Surgery Physician Taxonomy 207XP3100X · Licence 187405 (OR)

Record details

NPI number1306109954
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 19, 2012
Last updated in NPPESJuly 28, 2023
Certification dateJuly 28, 2023
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare