Active NPI
James Gregory Roberts, M.D., R.V.T. FACS
- Vascular Surgery Physician
- Modesto, CA
National Provider Identifier
1356346936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- CDR.0001339
- Practice address
- 1541 Florida Ave Ste 305
Modesto, CA 95350-4439 - Phone
- (209) 575-5833
- Fax
- (209) 575-5836
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD60422790 | WA | |
| Vascular Surgery Physician | 2086S0129X | MD60422790 | WA | |
| Vascular Surgery Physician | 2086S0129X | 61178 | AZ | |
| Vascular Surgery Physician | 2086S0129X | MC-0454 | ID | |
| Vascular Surgery Physician | 2086S0129X | CDR.0001339 | CO | Primary |
Addresses
Primary practice location
1541 Florida Ave Ste 305
Modesto, CA 95350-4439
Mailing address
1800 15TH St. Ste 220
Greeley, CO 80631
Phone (970) 810-5462
Other practice location 1
1100 Goethals Dr Ste E
Richland, WA 99352-3301
Phone (509) 942-3095
Other practice location 2
1800 15th st.
ste 220
greeley, CO 80631
Phone (970) 810-5462
Other practice location 3
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 302-2800
Other practice location 4
2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone (719) 776-6700
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 091474 | Medicaid | AZ | |
| 4069830 | Other | TN | BLUE CROSS BLUE SHIELD |
| 61178 | Other | AZ | AZ LICENSE |
| 061707311 | Medicaid | TN | |
| 1212093 | Other | TN | CHA HEALTH |
| TN0101 | Other | TN | JOHN DEERE HEALTH |
| 325383 | Other | WA | STATE L&I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Louisville School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1541 Florida Ave
Suite 305
Modesto, CA 95350-4439
Phone (209) 577-3388
Hospital & facility affiliations
- Doctors Medical Center
- Adventist Health Sonora
- Mercy Medical Center
- Emanuel Medical Center
- Adventist Health Lodi Memorial
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 1-10 |
| Leg revascularization (restoring blood flow) | 43 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40468 | CO | MD | Licensed Practical Nurse |
| 37706 | TN | MD | Pharmacist |
| CDR.0001339 | CO | MD | Vascular Surgery Physician |
| MD60422790 | WA | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Physician Partners | Current | Accepting new patients | |
| Intermountain Medical Group Grand Junction, LLC | Current | Accepting new patients | |
| Intermountain Medical Group Grand Junction, LLC | Current | Accepting new patients | |
| First Choice Physician Partners | Current | Accepting new patients | |
| First Choice Physician Partners | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Surgery | Current | Accepting new patients |
| First Choice Physician Partners | Surgery | Past | Accepting new patients |
| J. Gregory Roberts, MD, RVT, PC Dba Mantle Clinic III | Past | Accepting new patients | |
| Tennessee Surgical Specialists, PC | Surgery | Past | Accepting new patients |
Locations
1541 Florida Ave
Ste 305
Modesto, CA 95350
Phone (209) 575-5833
1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864
1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810
2643 Patterson Rd
Ste 605
Grand Junction, CO 81506
Phone (970) 244-2482
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412
1401 Court St
Pueblo, CO 81003
Phone (719) 562-2300
Interoperability endpoints
- james.roberts.1@14035.direct.athenahealth.com
- jroberts1563269@direct.trinity-health.org
Organizations & group practices 10
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.
-
- Neurological Surgery Physician
- Modesto, CA
- NPI 1104183052
-
- Orthopaedic Surgery Physician
- Grand Junction, CO
- NPI 1356765556
-
- Family Medicine Physician
- Palm Springs, CA
- NPI 1558797118
-
- Ophthalmology Physician
- El Monte, CA
- NPI 1912732892
-
- Durable Medical Equipment & Medical Supplies
- Grand Junction, CO
- NPI 1609737618
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
-
- Specialist
- Knoxville, TN
- NPI 1609075464
-
- Surgery Physician
- Knoxville, TN
- NPI 1093877557
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Merced, CA
- NPI 1518018191
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1184654923
-
- General Acute Care Hospital
- Turlock, CA
- NPI 1396087672
-
- General Acute Care Hospital
- Lodi, CA
- NPI 1316938301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1356346936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 15TH ST. STE 220",
"city": "GREELEY",
"state": "CO",
"postal_code": "80631",
"telephone_number": "970-810-5462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1541 FLORIDA AVE STE 305",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504439",
"telephone_number": "209-575-5833",
"fax_number": "209-575-5836"
}
],
"practiceLocations": [
{
"address_1": "1100 Goethals Dr Ste E",
"address_purpose": "LOCATION",
"city": "Richland",
"state": "WA",
"postal_code": "993523301",
"country_code": "US",
"telephone_number": "509-942-3095",
"fax_number": "509-942-3097",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1800 15th st.",
"address_2": "ste 220",
"address_purpose": "LOCATION",
"city": "greeley",
"state": "CO",
"postal_code": "80631",
"country_code": "US",
"telephone_number": "970-810-5462",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1055 N Curtis Rd",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837061309",
"country_code": "US",
"telephone_number": "208-302-2800",
"fax_number": "208-302-2825",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2222 N Nevada Ave",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809076819",
"country_code": "US",
"telephone_number": "719-776-6700",
"fax_number": "719-776-6780",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "JAMES",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "M.D., R.V.T. FACS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD60422790",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WA",
"license": "MD60422790",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AZ",
"license": "61178",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "ID",
"license": "MC-0454",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "CO",
"license": "CDR.0001339",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "091474",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4069830",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ LICENSE",
"identifier": "61178",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061707311",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA HEALTH",
"identifier": "1212093",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH",
"identifier": "TN0101",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "325383",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.