Individual provider Active NPI

Jason D. Roos, D.O.

  • Facial Plastic Surgery Physician
  • Visalia, CA
National Provider Identifier
1205147659
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
20A18178 Issued in CA
Practice address
805 W Acequia Ave Ste 1B
Visalia, CA 93291-6163
Phone
(559) 409-4720
Fax
(559) 409-4713
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X OP60519665 WA
Facial Plastic Surgery Physician 207YS0123X 5101018567 MI
Facial Plastic Surgery Physician 207YS0123X 20A18178 CA Primary

Addresses

Primary practice location

805 W Acequia Ave Ste 1B
Visalia, CA 93291-6163

Mailing address

805 W Acequia Ave Ste 1B
Visalia, CA 93291-6163
Phone (559) 409-4720

Other practice location 1

3553 Camino Mira Costa Ste A
San Clemente, CA 92672-3512
Phone (559) 409-4720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200507001336 CA Practitioner - Otolaryngology 2365608189 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason Roos DO a Professional Medical CorporationGroup PAC ID 4789082561, 10 clinicians

Practice addresses (Care Compare)

1700 W Walnut Ave
Suite a
Visalia, CA 93277-6233
Phone (559) 409-4720

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions28
Removal or shaving of skin growth1-10
Skin biopsy27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18178CAMDFacial Plastic Surgery Physician
18178CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reedley Community Hospital CurrentSince Nov 1, 2022 Accepting new patients
Reedley Community Hospital CurrentSince Nov 1, 2022 Accepting new patients
Adventist Health Physicians Network CurrentSince Nov 1, 2022 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Nov 1, 2022 Accepting new patients
Jason Roos DO a Professional Medical Corporation CurrentSince Oct 1, 2021 Accepting new patients
Visalia Medical Clinic, Inc. Current Accepting new patients
Kaweah Delta Health Care Inc CurrentSince May 1, 2020 Accepting new patients
First Choice Urgent Care PC PastSince Sep 1, 2014 Accepting new patients
Rockwood Clinic PS Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Telegraph Urgent Care PLLC Past Accepting new patients

Locations

1680 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 401-6058

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

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

3553 Camino Mira Costa
San Clemente, CA 92672
Phone (949) 240-7070

3553 Camino Mira Costa
Ste D
San Clemente, CA 92672
Phone (949) 200-7737

3553 Camino Mira Costa
Ste A
San Clemente, CA 92672
Phone (949) 369-5932

2059 Hillman St
Tulare, CA 93274
Phone (559) 605-0090

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

5400 W Hillsdale Ave
Visalia, CA 93291
Phone (553) 733-5222

5530 Avenida de los Robles
Visalia, CA 93291
Phone (559) 733-5050

1700 W Walnut Ave
#A
Visalia, CA 93277
Phone (559) 409-4720

805 W Acequia Ave
Ste 1B
Visalia, CA 93291
Phone (559) 409-4720

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jasonroos@vmchealth.allscriptsdirect.net
  • Direct secure messaging: jroos@valleyent.emadirect.md
  • Direct secure messaging: jroos873579@direct.memorialcare.org

Organizations & group practices 13

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

View all 13

Hospital & facility affiliations 1

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1205147659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W ACEQUIA AVE STE 1B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916163",
            "telephone_number": "559-409-4720",
            "fax_number": "559-409-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W ACEQUIA AVE STE 1B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916163",
            "telephone_number": "559-409-4720",
            "fax_number": "559-409-4713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3553 Camino Mira Costa Ste A",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926723512",
            "country_code": "US",
            "telephone_number": "559-409-4720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOS",
        "first_name": "JASON",
        "middle_name": "D.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WA",
            "license": "OP60519665",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "5101018567",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "20A18178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.