Individual provider Active NPI

Grant W Rogero, MD

  • Diagnostic Radiology Physician
  • Lodi, CA
National Provider Identifier
1154330389
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G63582 Issued in CA
Practice address
1121 W Vine St
Suite 15
Lodi, CA 95240
Phone
(209) 334-4416
Fax
(209) 371-0119
NPI assigned
Aug 5, 2006
Last updated
Oct 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G63582 CA Primary

Addresses

Primary practice location

1121 W Vine St
Suite 15
Lodi, CA 95240

Mailing address

PO Box 15498
Sacramento, CA 95857
Phone (559) 455-4000

Other identifiers 1

IdentifierTypeStateIssuer
00G635820MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071018000549 CA Practitioner - Diagnostic Radiology 5193811347 Reassigns benefits to 7 organizations
I20251015001335 HI Practitioner - Diagnostic Radiology 5193811347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

1031 S Fairmont Ave
Lodi, CA 95240-5112
Phone (209) 334-8580

27200 Calaroga Ave
Hayward, CA 94545-4339
Phone (209) 647-2184

500 W Hospital Rd
French Camp, CA 95231-9693
Phone (209) 468-6000

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

92 -1097 Koio Dr
M 335
Kapolei, HI 96707-2296
Phone (209) 647-2184

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.97 of 100Reported as group
Quality
91.92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G63582CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Golden Gate Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 15, 2009 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2025 Accepting new patients
San Joaquin Faculty Medical Group CurrentSince Apr 16, 2025 Accepting new patients
Central Valley Imaging Medical Associates, Inc Diagnostic Radiology CurrentSince May 1, 2025 Accepting new patients
Lodi Memorial Hospital Association Inc CurrentSince Jun 1, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2025 Accepting new patients
Pleasanton Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Apr 16, 2026 Accepting new patients
County of San Joaquin CurrentSince Sep 20, 2009 Accepting new patients
Golden Gate Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Dec 15, 2009 Accepting new patients
Delta Radiology, Inc. CurrentSince Feb 1, 2003 Accepting new patients
County of San Joaquin CurrentSince Sep 20, 2009 Accepting new patients
Lodi Memorial Hospital Association, Inc Current Accepting new patients
Delta Radiology, Inc. CurrentSince Feb 1, 2003 Accepting new patients
Pleasanton Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Apr 16, 2026 Accepting new patients
Dignity Health Past Accepting new patients
Delta Sierra Medical Group, Inc PastSince Dec 7, 2025 Accepting new patients
Delta Radiology Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

1031 S Fairmont Ave
Lodi, CA 95240
Phone (209) 333-7422

1121 W Vine St
Ste 15
Lodi, CA 95240
Phone (209) 333-7422

1121 W Vine St
Ste 16
Lodi, CA 95240
Phone (209) 263-0200

541 S Ham Ln
Ste B
Lodi, CA 95242
Phone (209) 224-8940

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

520 W I St
Los Banos, CA 93635
Phone (209) 724-0316

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

845 Jackson St
San Francisco, CA 94133
Phone (415) 677-2300

10200 Trinity Pkwy
Ste 204
Stockton, CA 95219
Phone (209) 451-3920

1617 N California St
Ste 1B
Stockton, CA 95204
Phone (209) 948-6063

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

1420 N Tracy Blvd
Tracy, CA 95376
Phone (209) 832-6018

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1154330389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15498",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95857",
            "telephone_number": "559-455-4000",
            "fax_number": "559-455-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W VINE ST",
            "address_2": "SUITE 15",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95240",
            "telephone_number": "209-334-4416",
            "fax_number": "209-371-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERO",
        "first_name": "GRANT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G63582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G635820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.