NPIMap

Individual provider Active NPI

Roscoe S Nelson, MD

  • Urology Physician
  • Draper, UT
National Provider Identifier
1962487462
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
13713178-1205 Issued in UT
Practice address
807 E Pioneer Rd Unit 105
Draper, UT 84020-9343
Phone
(480) 686-5090
NPI assigned
Dec 7, 2005
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 13713178-1205 UT Primary
Urology Physician 208800000X 27180 AZ

Addresses

Primary practice location

807 E Pioneer Rd Unit 105
Draper, UT 84020-9343

Mailing address

807 E Pioneer Rd Unit 105
Draper, UT 84020-9343

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241105002803 UT Practitioner - Urology 0941261291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of California, San Diego School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13713178-1205UTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC CurrentSince Dec 1, 2024 Accepting new patients
Granger Medical Clinic PC Family Medicine Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Dec 1, 2024 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Dec 1, 2024 Accepting new patients
Granger Medical Clinic PC CurrentSince Dec 1, 2024 Accepting new patients
Peri Health & Hormones Urology Past Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients
Arizona Urology Specialists, PLLC Past Accepting new patients

Locations

1159 E 200 N
Ste 300
American Fork, UT 84003
Phone (801) 756-7609

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

2965 W 3500 S
#902
West Valley City, UT 84119

Interoperability endpoints

  • Direct secure messaging: roscoe.nelson@urologyaz.eclinicaldirectplus.com

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1962487462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 E PIONEER RD UNIT 105",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 E PIONEER RD UNIT 105",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209343",
            "telephone_number": "480-686-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROSCOE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "13713178-1205",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "27180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.