Individual provider Active NPI

Pedro Jose Roque Jr., M.D.

  • Emergency Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1316197775
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
RESIDENCY Issued in AZ
Practice address
7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone
(480) 882-4809
NPI assigned
Sep 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X RESIDENCY AZ Primary
Emergency Medicine Physician 207P00000X 51318 TN
Student in an Organized Health Care Education/Training Program 390200000X 62764 NY
Emergency Medicine Physician 207P00000X 43906 AZ

Addresses

Primary practice location

7400 E Osborn Rd
Scottsdale, AZ 85251-6432

Mailing address

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (480) 882-4809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20140827002579 TN Practitioner - Emergency Medicine 6709000292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Harvard Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middle Tennessee Emergency Physicians, P.C.Group PAC ID 3678464526, 85 clinicians

Practice addresses (Care Compare)

520 W Main St
Smithville, TN 37166-1138
Phone (615) 215-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RESIDENCYAZMDEmergency Medicine Physician
62764NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Sep 25, 2022 Accepting new patients

Locations

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

1080 N Ellington Pkwy
Lewisburg, TN 37091
Phone (615) 359-6241

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

5127 Veterans Pkwy
Murfreesboro, TN 37128
Phone (615) 396-4100

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

4220 Harding Pike
Nashville, TN 37205
Phone (615) 222-2111

520 W Main St
Smithville, TN 37166
Phone (615) 215-5000

401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164

324 Doolittle Rd
Woodbury, TN 37190
Phone (615) 563-4001

Organizations & group practices 1

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 3

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1316197775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516432",
            "telephone_number": "480-882-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516432",
            "telephone_number": "480-882-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "PEDRO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "RESIDENCY",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "51318",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "62764",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "43906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.