| Grant W Rogero, MD | |
|
1121 W Vine St, Suite 15, Lodi, CA 95240 | |
| (209) 334-4416 | |
| (209) 371-0119 |
| Full Name | Grant W Rogero |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 38 Years |
| Location | 1121 W Vine St, Lodi, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154330389 | NPI | - | NPPES |
| 00G635820 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | G63582 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventist Health Lodi Memorial | Lodi, CA | Hospital |
| Watsonville Community Hospital | Watsonville, CA | Hospital |
| St Rose Hospital | Hayward, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Adventist Health Physicians Network | 3274580972 | 572 |
| Delta Radiology Inc | 5294795308 | 25 |
| County Of San Joaquin | 6002703436 | 161 |
| Lodi Memorial Hospital Association Inc | 7618880717 | 39 |
| Central Valley Imaging Medical Associates Inc | 8628064953 | 49 |
| Entity Name | County Of San Joaquin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801830583 PECOS PAC ID: 6002703436 Enrollment ID: O20040301001287 |
| Entity Name | Central Valley Imaging Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275523169 PECOS PAC ID: 8628064953 Enrollment ID: O20040422000783 |
| Entity Name | Delta Radiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740305846 PECOS PAC ID: 5294795308 Enrollment ID: O20041013000834 |
| Entity Name | Adventist Health Physicians Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063718583 PECOS PAC ID: 3274580972 Enrollment ID: O20050407000633 |
| Entity Name | Lodi Memorial Hospital Association Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861649352 PECOS PAC ID: 7618880717 Enrollment ID: O20050517000577 |
| Entity Name | San Joaquin Faculty Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225063761 PECOS PAC ID: 4082631395 Enrollment ID: O20051026000742 |
| Entity Name | Golden Gate Radiology Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073654232 PECOS PAC ID: 4880792779 Enrollment ID: O20070530000364 |
| Mailing Address | Practice Location Address |
|---|---|
| Grant W Rogero, MD Po Box 15498, Sacramento, CA 95857 Ph: (559) 455-4000 | Grant W Rogero, MD 1121 W Vine St, Suite 15, Lodi, CA 95240 Ph: (209) 334-4416 |
Adam Joseph Woodyard, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 975 S Fairmont Ave, Lodi, CA 95240 Phone: 209-334-3411 | |
Maxine Louise Del Paine, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1121 W Vine Street, Suite 15, Lodi, CA 95240 Phone: 209-334-4416 Fax: 209-371-0119 | |
Laszlo B Fodor, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1121 W Vine Street, Suite 15, Lodi, CA 95240 Phone: 209-334-4416 Fax: 209-371-0119 | |
Frank M Hartwick, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1121 W Vine Street, Suite 15, Lodi, CA 95240 Phone: 209-334-4416 Fax: 209-371-0119 | |
Daniel W. Terry Jr., MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1121 W Vine Street, Suite 15, Lodi, CA 95240 Phone: 209-334-4416 Fax: 209-371-0119 | |
Travers J Mcloughlin, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 311 S Ham Ln, Lodi, CA 95242 Phone: 209-365-1761 Fax: 209-333-3673 |