Ms Cynthia Cecilia Roque, MD is a medicare enrolled "General Practice" physician in Fort Defiance, Arizona. Her current practice location is
Corner Of Route N12 And N7, Corner Of Route N12 And N7, Fort Defiance, Arizona. You can reach out to her office (for appointments etc.) via phone at
(928) 729-8000.
Ms Cynthia Cecilia Roque is licensed to practice in Florida (license number ME134151) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609050293.
Physician's Profile
| Full Name | Ms Cynthia Cecilia Roque |
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| Gender | Female |
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| Speciality | General Practice |
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| Location | Corner Of Route N12 And N7, Fort Defiance, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1609050293
- Provider Enumeration Date: 12/19/2007
- Last Update Date: 02/23/2026
Medicare PECOS Information:
- PECOS PAC ID: 5496870834
- Enrollment ID: I20231125000024
Medical Identifiers
Medical identifiers for Ms Cynthia Cecilia Roque such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1609050293 | NPI | - | NPPES |
| 004236346 | Medicaid | CT | |
| 023853200 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208000000X | Pediatrics | 048900 (Connecticut) | Secondary |
| 208D00000X | General Practice | ME134151 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Cynthia Cecilia Roque allows following entities to bill medicare on her behalf.
| Entity Name | The Fort Defiance Indian Hospital Board, Incorporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477876639 PECOS PAC ID: 0941336697 Enrollment ID: O20100429001153 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Cynthia Cecilia Roque is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Ms Cynthia Cecilia Roque, MD Po Box 649, Fort Defiance, AZ 86504-0649 Ph: () - | Ms Cynthia Cecilia Roque, MD Corner Of Route N12 And N7, Corner Of Route N12 And N7, Fort Defiance, AZ 86504-0649 Ph: (928) 729-8000 |
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