Individual provider Active NPI

Ronald Regin Roque, MD

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1306588199
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A197809 Issued in CA
Practice address
4770 W Herndon Ave Ste 107
Fresno, CA 93722-8401
Phone
(559) 450-6310
Fax
(559) 450-6311
NPI assigned
Apr 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A197809 CA Primary

Addresses

Primary practice location

4770 W Herndon Ave Ste 107
Fresno, CA 93722-8401

Mailing address

2458 Glen Haig Way
San Jose, CA 95148-4113
Phone (408) 893-1453

Other practice location 1

1313 E Herndon Ave Ste 105
Fresno, CA 93720-3306
Phone (559) 450-5372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250225001435 CA Practitioner - Family Practice 6002336765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

4770 W Herndon Ave
Suite 107
Fresno, CA 93722-8401
Phone (559) 450-6310

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Current Accepting new patients
Saint Agnes Medical Foundation Family Medicine CurrentSince Jan 19, 2025 Accepting new patients

Locations

1313 E Herndon Ave
Ste 105
Fresno, CA 93720
Phone (559) 448-8481

4770 W Herndon Ave
Ste 107
Fresno, CA 93722
Phone (559) 450-6310

1111 E Spruce Ave
Ste 431
Fresno, CA 93720
Phone (559) 450-5611

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

Interoperability endpoints

  • Direct secure messaging: rroque2718599@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1306588199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 GLEN HAIG WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951484113",
            "telephone_number": "408-893-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 W HERNDON AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228401",
            "telephone_number": "559-450-6310",
            "fax_number": "559-450-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 E Herndon Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203306",
            "country_code": "US",
            "telephone_number": "559-450-5372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "RONALD REGIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A197809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.