Active NPI
Preston A Roche
- Military Health Care Provider
- San Antonio, TX
National Provider Identifier
1265135495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- BP10082348
- Practice address
- 4502 Medical Dr
San Antonio, TX 78229-4402 - Phone
- (210) 358-4000
- NPI assigned
- Mar 27, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | BP10082348 | TX | Primary |
Addresses
Primary practice location
4502 Medical Dr
San Antonio, TX 78229-4402
Mailing address
132 Purefoy Rd
Chapel Hill, NC 27514-4853
Phone (970) 449-2615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260430003483 | TX | Order and Referring Only - Psychiatry | 4880161439 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10082348 | TX | MD | Military Health Care Provider |
Interoperability endpoints
- proche37402@direct.utmsa.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693094400000",
"number": "1265135495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 PUREFOY RD",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275144853",
"telephone_number": "970-449-2615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCHE",
"first_name": "PRESTON",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-27",
"last_updated": "2023-08-27",
"certification_date": "2023-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "TX",
"license": "BP10082348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.