Active NPI
Vance Roget, M.D.
- Specialist
- Modesto, CA
National Provider Identifier
1417976366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A414600
- Practice address
- 1130 Coffee Road
Suite 3-B
Modesto, CA 95355 - Phone
- (209) 571-3525
- Fax
- (209) 571-8616
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A414600 | CA | Primary |
Addresses
Primary practice location
1130 Coffee Road
Suite 3-B
Modesto, CA 95355
Mailing address
1130 Coffee Road
Suite 3-B
Modesto, CA 95355
Phone (209) 571-3525
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041013001166 | CA | Practitioner - Physical Medicine and Rehabilitation | 3577523620 | Practice locations: Modesto, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A414600 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417976366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 COFFEE ROAD",
"address_2": "SUITE 3-B",
"city": "MODESTO",
"state": "CA",
"postal_code": "95355",
"telephone_number": "209-571-3525",
"fax_number": "209-571-8616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 COFFEE ROAD",
"address_2": "SUITE 3-B",
"city": "MODESTO",
"state": "CA",
"postal_code": "95355",
"telephone_number": "209-571-3525",
"fax_number": "209-571-8616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGET",
"first_name": "VANCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A414600",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.