JAMES ROAT JR. M.D.
NPI 1275826901
Internal Medicine - Gastroenterology in Lincoln, NE

Q: What is James Roat's NPI number?

The NPI number for James Roat is 1275826901. It was assigned to this individual provider in the NPPES registry on May 27, 2011.

Q: What is James Roat's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for James Roat was last updated on March 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 27, 2011PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

4545 R ST STE 100, LINCOLN, NE 68503(402) 465-4545(402) 465-9011 Get Directions Write a Review

NPPES record last updated: March 12, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 12, 2019, Jul 24, 2018, Jul 10, 2017 and 1 more (4 updates tracked since 2017).

On this page

About James Roat Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES ROAT JR. M.D. (NPI 1275826901) is an individual gastroenterology provider in Lincoln, Nebraska, licensed in Nebraska (30525) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Bryan Medical Center, and is a graduate of University Of Minnesota Medical School (2011).

NPPES Registry Identity

NPI1275826901

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameJAMES ROAT JR.Credential: M.D.

Location Address4545 R ST STE 100Lincoln, NE 68503-3799

Mailing Address4545 R St Ste 100Lincoln, NE 68503-3799 · (402) 465-4545 · Fax (402) 465-9011

Phone(402) 465-4545

Fax(402) 465-9011

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 2011

Enumeration DateMay 27, 2011

Last NPPES UpdateMarch 12, 20194 updates tracked since enumeration

✔ NPI 1275826901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Licenses✔ Licensed in NE · 30525✔ Licensed in OH · 35123722

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 35.123722 (OH)

4545 R ST STE 100, Lincoln, NE 68503

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Other Identifiers 1

Other30525NE · State Of Nebraska

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Roat Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810267655

PECOS Enrollment IDI20180501001991

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 22

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, vedolizumab, intravenous, 1 mg J3380

Vedolizumab is a medication given via injection. It's used to treat certain bowel conditions (such as Crohn's disease, ulcerative colitis) by reducing inflammation. It works by blocking a certain protein that causes this inflammation.

7,200 services20 patients

Injection, infliximab, excludes biosimilar, 10 mg J1745

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

1,260 services15 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

190 services190 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

87 services85 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

52 services35 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

48 services47 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

46 services46 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

45 services45 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

43 services40 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

36 services33 patients

Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43259

This procedure involves a flexible tube with a camera, called an endoscope, inserted through your mouth to examine your esophagus, stomach, and upper small bowel. An ultrasound device on the endoscope helps get detailed images. It's safe and helps diagnose various conditions.

30 services30 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

24 services20 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

23 services23 patients

Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43242

This procedure involves using an ultrasound to guide a needle to specific areas in the esophagus, stomach, or upper small bowel. A flexible endoscope is used to reach these areas. The needle collects a small sample for testing.

22 services20 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

21 services15 patients

Administration of chemotherapy into vein, each additional hour 96415

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

20 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

19 services19 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

18 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

15 services15 patients

Insertion of stent into pancreatic or bile duct using a flexible endoscope 43274

This procedure involves the placement of a tiny tube, known as a stent, into your pancreatic or bile duct. A flexible endoscope, a long, thin instrument with a light and camera, is used. It aids in relieving blockages and improving flow in these ducts.

14 services11 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bryan Medical Center

Acute Care Hospitals · Lincoln, NE

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280003

Location1600 South 48th StLincoln, NE 68506 · Lancaster County

Emergency services Birthing friendly

The Nebraska Medical Center

Acute Care Hospitals · Omaha, NE

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280013

Location987400 Nebraska Medical CenterOmaha, NE 68198 · Douglas County

Emergency services Birthing friendly

Chi Health St. Elizabeth

Acute Care Hospitals · Lincoln, NE

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280020

Location555 South 70th StLincoln, NE 68510 · Lancaster County

Emergency services Birthing friendly

York General Hospital

Critical Access Hospitals · York, NE

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number281336

Location2222 N Lincoln AveYork, NE 68467 · York County

Emergency services

Memorial Health Care Systems

Critical Access Hospitals · Seward, NE

OwnershipVoluntary non-profit - Private

CMS Certification Number281339

Location300 North Columbia AveSeward, NE 68434 · Seward County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.35 typical visit price

range $52.69 – $160.21

Typical copayment $30.33 (range $13.17 – $40.05)

Most-billed visit code 99204

Established Patient

$93.55 typical visit price

range $16.90 – $131.25

Typical copayment $23.38 (range $4.22 – $32.81)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISSA CLAIRE SJOBERG PA-C

Physician Assistant

4545 R ST STE 100
LINCOLN, NE 68503

Lancaster County (402) 465-4545

DAVID PATRICK NEWTON M.D.

Internal Medicine (Gastroenterology)

4545 R ST STE 100
LINCOLN, NE 68503

Lancaster County (402) 465-4545

SAMANTHA LYN NICE APRN

Nurse Practitioner (Family)

4545 R ST STE 100
LINCOLN, NE 68503

Lancaster County (402) 465-4545

WILLIAM JAY LAWTON II M.D.

Internal Medicine (Gastroenterology)

4545 R ST STE 100, GASTROENTEROLOGY SPECIALTIES P.C.
LINCOLN, NE 68503

Lancaster County (402) 465-4545

DR. ALEXANDER WILLIAM PRAUS MD

Internal Medicine (Gastroenterology)

4545 R ST STE 100
LINCOLN, NE 68503

Lancaster County (402) 465-4545

DR. MARK AARON WELLS M.D.

Internal Medicine (Gastroenterology)

4545 R ST STE 100
LINCOLN, NE 68503

Lancaster County (402) 465-4545

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Roat's NPI number?

The NPI number for James Roat is 1275826901. It was assigned to this individual provider in the NPPES registry on May 27, 2011.

Where is James Roat located?

James Roat practices at 4545 R St Ste 100, Lincoln, NE 68503. The listed phone number is (402) 465-4545.

What is James Roat's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is James Roat enrolled in Medicare?

Yes. James Roat is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does James Roat accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 3 other insurers list James Roat as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is James Roat affiliated with any hospitals?

According to CMS data, James Roat is affiliated with Bryan Medical Center, The Nebraska Medical Center, Chi Health St. Elizabeth, York General Hospital and Memorial Health Care Systems.

When was this NPI record last updated?

The NPPES record for James Roat was last updated on March 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.