Shelley G Roque-Lichtig, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME115186 Issued in FL

Practice address

1094 Military TRL
Jupiter, FL 33458-7021

Phone

(561) 622-6111

Fax

(855) 215-9930

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Pain Management and Wellness CenterGroup PAC ID 5991128969, 3 clinicians

H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253
• Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287
• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
• Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelley.roque-lichtig.1@32459.direct.athenahealth.com

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.

• Advanced Pain Management and Wellness Center

  • Pain Medicine (Anesthesiology) Physician
  • Palm Beach Gardens, FL
  • NPI 1689294621
  Medicare reassignment Care Compare group NPD
• The Medical Group of South Florida Inc

  • Specialist
  • West Palm Beach, FL
  • NPI 1700176013
  NPD (past)
• The Medical Group of South Florida, Inc

  • Specialist
  • West Palm Beach, FL
  • NPI 1023454063
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Medical Center, Inc.

  • General Acute Care Hospital
  • West Palm Beach, FL
  • NPI 1770515991
  Care Compare affiliation
• Jupiter Medical Center, Inc.

  • General Acute Care Hospital
  • Jupiter, FL
  • NPI 1295721090
  Care Compare affiliation
• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation
• Palm Beach Gardens Community Hospital, Inc.

  • General Acute Care Hospital
  • Palm Beach Gardens, FL
  • NPI 1144251216
  Care Compare affiliation

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1265875249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 BURNS RD STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104328",
            "telephone_number": "561-944-5534",
            "fax_number": "561-461-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-622-6111",
            "fax_number": "855-215-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE-LICHTIG",
        "first_name": "SHELLEY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME115186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012929000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Rogean, APRN
• Caitlin Roggin
• Kaitlyn Anne Romano, APRN / AGACNP-BC
• Lauren Romero, M.ED, LMHC
• Rooted in Lifestyle, L.L.C.
• Louis C. Rosainz, M.D.
• Rose Hawley Physical Therapy LLC
• Rose Serenity Behavior Analysis LLC
• Rose Serenity Wellness Center Inc
• Andrea Elyse Rosenberg, M.S. CCC-SLP

• Family Medicine Physician in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.