Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas James Roth, PA-C

Individual provider Physician Assistant · NPI 1386372050

Nicholas James Roth, PA-C is a Physician Assistant in Massapequa Park, New York. Qualified in 2024, 2 years ago. Practices with Mount Sinai School of Medicine, a 151-clinician group and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

136 Kinsella Ave
Massapequa Park, NY 11762-3337
Phone: (516) 462-2001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1386372050
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 10, 2022
Last updated in NPPESAugust 10, 2022
Certification dateAugust 10, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mount Sinai School Of Medicine — 151 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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