Individual provider Active NPI

Frine T Roca, MD

  • Pediatrics Physician
  • Fort Payne, AL
National Provider Identifier
1265487185
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
00016324 Issued in AL
Practice address
205 Grand Ave NW
Ste B
Fort Payne, AL 35967-2107
Phone
(256) 979-1515
Fax
(256) 979-1517
NPI assigned
May 23, 2006
Last updated
Jan 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 00016324 AL Primary

Addresses

Primary practice location

205 Grand Ave NW
Ste B
Fort Payne, AL 35967-2107

Mailing address

205 Grand Ave NW
Ste B
Fort Payne, AL 35967-2107
Phone (256) 979-1515

Other identifiers 3

IdentifierTypeStateIssuer
51003773OtherALBCBS
541385602MedicaidAL
051557587MedicaidAL

Other names 1

  • Dr. Frine E De Dios Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20040416001185 AL Practitioner - Pediatric Medicine 6901891167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Healthcare LLCGroup PAC ID 2264682533, 3 clinicians

Practice addresses (Care Compare)

205 Grand Ave NW
Suite a
Fort Payne, AL 35967-2107
Phone (256) 635-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00016324ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthcare LLC CurrentSince Nov 1, 2016 Accepting new patients
Med Care LLC Past Accepting new patients
Valley Head Clinic LLC Past Accepting new patients

Locations

601 Corley Ave
Boaz, AL 35957
Phone (256) 558-3896

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1265487185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 GRAND AVE NW",
            "address_2": "STE B",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672107",
            "telephone_number": "256-979-1515",
            "fax_number": "256-979-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 GRAND AVE NW",
            "address_2": "STE B",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672107",
            "telephone_number": "256-979-1515",
            "fax_number": "256-979-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCA",
        "first_name": "FRINE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "00016324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51003773",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541385602",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051557587",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRINE",
            "last_name": "DE DIOS",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.