Jared Michael Roberts

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13953401-1205 Issued in UT

Practice address

3943 E Pony Express Pkwy Ste 120
Eagle Mountain, UT 84005-5543

Phone

(801) 789-5566

Fax

(801) 642-2941

NPI assigned

Apr 6, 2020

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Family PracticeAlso: Sports Medicine

Education

University of Utah School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• American Fork Hospital Hospital, American Fork, UT, CCN 460023

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Premier Family Medical

  • Family Medicine Physician
  • Pleasant Grove, UT
  • NPI 1750725735
  Medicare reassignment Care Compare group NPD
• Premier Family Medical - City Center

  • Family Medicine Physician
  • Eagle Mountain, UT
  • NPI 1649160235
  NPD
• Premier Family Medical - Traverse Mountain

  • Family Medicine Physician
  • Lehi, UT
  • NPI 1003202730
  NPD

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

• Ihc Health Services, Inc.

  dba Intermountain Health Utah Valley Hospital

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health American Fork Hospital

  • General Acute Care Hospital
  • American Fork, UT
  • NPI 1912014358
  Care Compare affiliation

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1962031435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 200 N",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840425009",
            "telephone_number": "801-796-1333",
            "fax_number": "801-796-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3943 E PONY EXPRESS PKWY STE 120",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055543",
            "telephone_number": "801-789-5566",
            "fax_number": "801-642-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JARED",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "13953401-1205",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "UT",
            "license": "13953401-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn C Reynolds, DPT
• Ridgeline Mobility LLC
• Ridleys Family Markets Inc (Ridley's Pharmacy #1165)
• Ridleys Family Markets Inc (City Center Pharmacy)
• Rise & Thrive Counseling LLC
• Tyson Roberts, PA
• Jordan David Rupp, PHARMD
• Brenda Isui Sanchez Gomez
• Tamara Jean Sasser
• Kyler Saunders, DPT

• Family Medicine Physician in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.

Verify at the official NPI Registry.