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DR. JORDAN RUSSELL ROBERTS M.D.
NPI 1588043871
Family Medicine in Holladay, UT

Active since May 20, 2015PECOS EnrolledAccepts Medicare Assignment
999 E MURRAY HOLLADAY RD STE 207, HOLLADAY, UT 84117(801) 268-2584(801) 262-1168 Get Directions Write a Review

NPPES record last updated: September 15, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 15, 2018, Aug 29, 2016 (2 updates tracked since 2016).

About Dr. Jordan Russell Roberts M.d. NPPES

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

DR. JORDAN RUSSELL ROBERTS M.D. (NPI 1588043871) is an individual family medicine provider in Holladay, Utah, licensed in Utah (9897039-1205) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Intermountain Medical Center, and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1588043871
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JORDAN RUSSELL ROBERTSCredential: M.D.
Location Address999 E MURRAY HOLLADAY RD STE 207Holladay, UT 84117-5093
Mailing Address999 E Murray Holladay Rd Ste 207Holladay, UT 84117-5093 · (801) 268-2584 · Fax (801) 262-1168
Phone(801) 268-2584
Fax(801) 262-1168
Sole ProprietorNo
Medical School CMSUniversity Of Arizona College Of MedicineGraduated 2015
Enumeration DateMay 20, 2015
Last NPPES UpdateSeptember 15, 20182 updates tracked since enumeration
✔ NPI 1588043871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 9897039-1205
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
999 E MURRAY HOLLADAY RD STE 207, Holladay, UT 84117
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Other Names 1

Former Name (1)Jordan Essary

Secondary Practice Location 1

Location 11250 E 3900 S Ste 260Salt Lake City, UT 84124-1371 · Phone (801) 265-2000 ext. 120 · Fax (801) 265-2008

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jordan Russell Roberts 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 ID8426354994
PECOS Enrollment IDI20180611001538
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Jordan Roberts reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Granger Medical Clinic PC
1.1 mi
Specialist
348 E 4500 S, SUITE 200
Salt Lake City, UT 84107
  • Reassigned Medicare billing, Utah enrollment
  • 190 clinicians in this Medicare group
NPI 1356425672 (801) 262-9800
Utah Healthcare Institute Inc
1.4 mi
Family Medicine
1250 E 3900 S, SUITE 260
Salt Lake City, UT 84124
  • Reassigned Medicare billing, Utah enrollment
  • 26 clinicians in this Medicare group
NPI 1376597344 (801) 265-2000
Granger Medical Specialists LLC
7.5 mi
Clinic/Center
2965 W 3500 S
West Valley City, UT 84119
  • Reassigned Medicare billing, Utah enrollment
  • 188 clinicians in this Medicare group
NPI 1376159368 (801) 965-3600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
118 services75 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
93 services93 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
88 services88 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
59 services59 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
56 services56 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.
54 services46 patients

Hospital Affiliations CMS Care Compare 2

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

Intermountain Medical Center

Acute Care Hospitals · Murray, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460010
Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County
Emergency services Birthing friendly

St Mark's Hospital

Acute Care Hospitals · Salt Lake City, UT
3/5 CMS rating
OwnershipProprietary
CMS Certification Number460047
Location1200 East 3900 SouthSalt Lake City, UT 84124 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84117 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers15 claims37 services$4.82 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers13 claims13 services$2.68 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$67.14 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$35.02 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

STACEY MILLS LAKE NP
Nurse Practitioner (Primary Care)
999 E MURRAY HOLLADAY RD STE 207
HOLLADAY, UT 84117
Salt Lake County (801) 268-2584
DR. RICHARD B GREMILLION MD
Internal Medicine (Rheumatology)
999 E MURRAY HOLLADAY RD STE 207
MILLCREEK, UT 84117
Salt Lake County (801) 965-3600
JOSHUA R LLOYD DO
Family Medicine
999 E MURRAY HOLLADAY RD STE 207
MILLCREEK, UT 84117
Salt Lake County (801) 965-3600

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 Jordan Roberts's NPI number?

The NPI number for Jordan Roberts is 1588043871. It was assigned to this individual provider in the NPPES registry on May 20, 2015. The provider is also known as Jordan Essary.

Where is Jordan Roberts located?

Jordan Roberts practices at 999 E Murray Holladay Rd Ste 207, Holladay, UT 84117. The listed phone number is (801) 268-2584.

What is Jordan Roberts's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jordan Roberts enrolled in Medicare?

Yes. Jordan Roberts 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.

Which organizations bill Medicare for Jordan Roberts's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Roberts reassigns Medicare benefits to 3 organizations: Granger Medical Clinic PC (Salt Lake City, UT), Utah Healthcare Institute Inc (Salt Lake City, UT) and Granger Medical Specialists LLC (West Valley City, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jordan Roberts's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jordan Roberts accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Jordan Roberts 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 Jordan Roberts affiliated with any hospitals?

According to CMS data, Jordan Roberts is affiliated with Intermountain Medical Center and St Mark's Hospital.

When was this NPI record last updated?

The NPPES record for Jordan Roberts was last updated on September 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.