Active NPI
Jose M. Roque, M.D.
- Gastroenterology Physician
- Orange, CA
National Provider Identifier
1154362010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G71898
- Practice address
- 230 S Main St
Suite 215
Orange, CA 92868-3851 - Phone
- (714) 937-9400
- Fax
- (714) 937-9404
- NPI assigned
- Jun 9, 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | G71898 | CA | Primary |
Addresses
Primary practice location
230 S Main St
Suite 215
Orange, CA 92868-3851
Mailing address
230 S Main St
Suite 215
Orange, CA 92868-3851
Phone (714) 937-9400
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G71898 | CA | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1154362010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 S MAIN ST",
"address_2": "SUITE 215",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683851",
"telephone_number": "714-937-9400",
"fax_number": "714-937-9404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 S MAIN ST",
"address_2": "SUITE 215",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683851",
"telephone_number": "714-937-9400",
"fax_number": "714-937-9404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUE",
"first_name": "JOSE",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G71898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.