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

Michael Roth

Individual provider Physician Assistant · NPI 1760927313

Michael Roth is a Physician Assistant in Jamaica, New York. Qualified in 2017, 9 years ago. Practices with Renaissance Medical Care PC, a 5-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
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Practice location Address checks out

8268 164th St Ste 1B-02
Jamaica, NY 11432-1121
Phone: (718) 883-3070
Fax: (718) 883-6115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 578 Adelphi St, East Meadow, NY 11554-3805 — (516) 862-0200

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1760927313
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 5, 2017
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Renaissance Medical Care Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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