DR. MARK D ROQUE M.D.
NPI 1164427043
Pediatrics in Simpsonville, SC
About Dr. Mark D Roque M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARK D ROQUE M.D. (NPI 1164427043) is an individual pediatrics provider in Simpsonville, South Carolina, licensed in South Carolina (21147) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Eastern Virginia Medical School (1998).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Mark D Roque M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Mark Roque reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Charleston, SC 29425
- Reassigned Medicare billing, South Carolina enrollment
- 140 clinicians in this Medicare group
Orlando, FL 32803
- Reassigned Medicare billing, Florida enrollment
- 3,005 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29680 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mark Roque's NPI number?
The NPI number for Mark Roque is 1164427043. It was assigned to this individual provider in the NPPES registry on June 16, 2005.
Where is Mark Roque located?
Mark Roque practices at 559 Harrison Bridge Rd, Simpsonville, SC 29680. The listed phone number is (864) 272-0388.
What is Mark Roque's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Mark Roque enrolled in Medicare?
Yes. Mark Roque is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Mark Roque's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Roque reassigns Medicare benefits to 2 organizations: Musc Affiliate Physicians (Charleston, SC) and Florida Hospital Medical Group Inc (Orlando, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Roque's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mark Roque accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next and UnitedHealthcare list Mark Roque as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mark Roque was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Mark D Roque, M.D. · NPI 1164427043
Pediatrics physician in Simpsonville, South Carolina. Individual provider, active in the CMS NPPES registry since June 16, 2005.
## Identity
- **NPI:** 1164427043 (Entity type: Individual)
- **Enumerated:** June 16, 2005
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 21147 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 559 HARRISON BRIDGE RD, Simpsonville, SC 29680-7004
- **Phone:** (864) 272-0388
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Musc Affiliate Physicians (NPI 1548849482, Charleston, SC); Florida Hospital Medical Group Inc (NPI 1225034234, Orlando, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Eastern Virginia Medical School, class of 1998
## Record status
- **NPPES last updated:** July 21, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1164427043) · Data from the CMS NPPES public registry.