DR. CESAR M ROCA JR. MD
NPI 1275533549
Orthopaedic Surgery in Daphne, AL

Active since July 28, 2005PECOS EnrolledAccepts Medicare Assignment
70.98/100
CMS Quality Rating
1505 DAPHNE AVE, DAPHNE, AL 36526(251) 625-2663(251) 625-3198 Get Directions Write a Review

NPPES record last updated: December 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Cesar M Roca Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CESAR M ROCA JR. MD (NPI 1275533549) is an individual orthopaedic surgery provider in Daphne, Alabama, licensed in Alabama (24792) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Tulane University School Of Medicine (1986).

NPPES Registry Identity

NPI1275533549
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. CESAR M ROCA JR.Credential: MD
Location Address1505 DAPHNE AVEDaphne, AL 36526-4298
Mailing Address1505 Daphne AveDaphne, AL 36526-4298 · (251) 625-2663 · Fax (251) 625-3198
Fax(251) 625-3198
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 1986
Enumeration DateJuly 28, 2005
Last NPPES UpdateDecember 30, 2024
NPPES CertifiedDecember 30, 2024
NPI 1275533549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in AL · 24792
Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1505 DAPHNE AVE, Daphne, AL 36526

Other Identifiers 2

Other200045505Railroad Medicare
Medicaid051552737AL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Cesar M Roca Jr. Md 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.

PECOS PAC ID8022917194
PECOS Enrollment IDI20040107000788
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
182 services108 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
96 services72 patients
X-ray of shoulder blade 73010
An X-ray of the shoulder blade is a quick, painless test that produces images of the bones in your shoulder area. It helps identify fractures, infections, or other abnormalities. You'll need to stay still while a machine sends a small amount of radiation through your shoulder to capture the image.
85 services66 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
56 services40 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
36 services36 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
28 services27 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36526 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

70.98/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.74
Promoting Interoperability84
Improvement Activities40
Cost51.88

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf L3660
DME-Orthotic Devices · category DF000N
1 supplier31 claims31 services$66.59 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology (Pain Medicine)
1505 DAPHNE AVE
DAPHNE, AL 36526
Family Medicine (Sports Medicine)
1505 DAPHNE AVE
DAPHNE, AL 36526
Nurse Practitioner
1505 DAPHNE AVE
DAPHNE, AL 36526
Physician Assistant
1505 DAPHNE AVE
DAPHNE, AL 36526
Physician Assistant
1505 DAPHNE AVE
DAPHNE, AL 36526
Physical Therapist
1505 DAPHNE AVE
DAPHNE, AL 36526
Occupational Therapist
1505 DAPHNE AVE
DAPHNE, AL 36526
Specialist
1505 DAPHNE AVE
DAPHNE, AL 36526

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 Cesar Roca's NPI number?

The NPI number for Cesar Roca is 1275533549. It was assigned to this individual provider in the NPPES registry on July 28, 2005.

Where is Cesar Roca located?

Cesar Roca practices at 1505 Daphne Ave, Daphne, AL 36526. The listed phone number is (251) 625-2663.

What is Cesar Roca's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Cesar Roca enrolled in Medicare?

Yes. Cesar Roca 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.

What insurance does Cesar Roca accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer list Cesar Roca 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 Cesar Roca was last updated on December 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.