Pedro J Roque, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

157218 Issued in NY

Practice address

600 Suffolk Ave Ste B
Brentwood, NY 11717-4311

Phone

(631) 435-2133

Fax

(631) 435-4365

NPI assigned

Oct 25, 2006

Sex

Male

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

Other names 1

• Dr. Pedro J Roque-Rodriguez Professional name

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

Specialty

Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Partnercare Physicians PLLCGroup PAC ID 9638593585, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24863/brand/1/csg/1/fhir/r4
• Direct secure messaging: pedro.roque.1@24863.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.

• Primary Partnercare Physicians PLLC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1891318168
  Medicare reassignment Care Compare group NPD

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

• Central Suffolk Hospital

  dba Peconic Bay Homehealth Services

  • Home Health Agency
  • Riverhead, NY
  • NPI 1932155678
  Care Compare affiliation
• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1275617987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD STE 328",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215329",
            "telephone_number": "516-233-2484",
            "fax_number": "516-304-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUFFOLK AVE STE B",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174311",
            "telephone_number": "631-435-2133",
            "fax_number": "631-435-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "PEDRO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-11-21",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "157218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00891974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEDRO",
            "last_name": "ROQUE-RODRIGUEZ",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amanda Beth Romano, LCSW
• Dayna Lynn Romano, B.S.
• Michael Stephen Romeu
• Tiffany Lynn Romeu, LPN
• Ropen Health Care Services Inc
• Wilda Rosario
• Andrea Frasca Rosenstein, FNP-BC
• Ross Acquisition LLC
• Ross Health Care Center, Inc. (Ross Health Care Center)
• Ross Opco LLC

• Internal Medicine Physician in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.