Active NPI
Robert R Roche, D.O.
- Family Medicine Physician
- West Seneca, NY
National Provider Identifier
1063459394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 226915
- Practice address
- 1026 Union Rd
West Seneca, NY 14224-3445 - Phone
- (716) 712-0851
- Fax
- (716) 712-0853
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 226915 | NY | Primary |
Addresses
Primary practice location
1026 Union Rd
West Seneca, NY 14224-3445
Mailing address
1026 Union Rd
West Seneca, NY 14224-3445
Phone (716) 712-0851
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00020842602 | Other | NY | UNIVERA |
| 0113010 | Other | NY | INDEPENDENT HEALTH |
| 02479505 | Medicaid | NY | |
| 000528306001 | Other | NY | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226915 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tat Sum Lee, M.D. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1063459394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 UNION RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142243445",
"telephone_number": "716-712-0851",
"fax_number": "716-712-0853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 UNION RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142243445",
"telephone_number": "716-712-0851",
"fax_number": "716-712-0853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCHE",
"first_name": "ROBERT",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "226915",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00020842602",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "0113010",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02479505",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000528306001",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Seneca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.