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

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1851615066

Mr. Jay Edward Roth, CRNP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2009, 17 years ago. Practices with Vital Healthcare Solutions, a 105-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
17
Licensed in
PA
In the registry since
2010
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

706 S 11th St #3B
Philadelphia, PA 19147-1968
Phone: (215) 913-7381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence SP010741 (PA)

Record details

NPI number1851615066
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorYes
NPI enumeratedMarch 16, 2010
Last updated in NPPESMarch 16, 2010

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Vital Healthcare Solutions — 105 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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