Individual provider Active NPI

Ashley Roque, MD

  • Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
  • Long Island City, NY
National Provider Identifier
1093058356
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084H0002X
License
298060 Issued in NY
Practice address
3030 Northern Blvd
Long Island City, NY 11101-2809
Phone
(212) 609-1920
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Psychiatry & Neurology) Physician 2084H0002X 298060 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3030 Northern Blvd
Long Island City, NY 11101-2809

Mailing address

220 E 42ND St # 910
New York, NY 10017-5806
Phone (347) 920-7015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190208001682 NY Order and Referring Only - NeurologyPractitioner - Neurology 9234477795

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
298060NYMDHospice and Palliative Medicine (Psychiatry & Neurology) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1093058356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 42ND ST # 910",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175806",
            "telephone_number": "347-920-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012809",
            "telephone_number": "212-609-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084H0002X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "298060",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.