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DR. MA. OLIVIA ROQUE SAN DIEGO MD
NPI 1285842997
Pediatrics in Chicago, IL

Active since May 18, 2007PECOS Enrolled
1044 N MOZART ST, STE 205, CHICAGO, IL 60622(773) 489-2912(773) 489-7330 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Ma. Olivia Roque San Diego Md NPPES

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

DR. MA. OLIVIA ROQUE SAN DIEGO MD (NPI 1285842997) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (036-130487) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285842997
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MA. OLIVIA ROQUE SAN DIEGOCredential: MD
Location Address1044 N MOZART ST, STE 205Chicago, IL 60622-2792
Mailing Address1044 N Mozart St, Ste 205Chicago, IL 60622-2792 · (773) 489-2912 · Fax (773) 489-7330
Phone(773) 489-2912
Fax(773) 489-7330
Sole ProprietorNo
Enumeration DateMay 18, 2007
Last NPPES UpdateDecember 21, 2021
NPPES CertifiedDecember 21, 2021
✔ NPI 1285842997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 036-130487
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1044 N MOZART ST, Chicago, IL 60622
Open in Google Maps ↗

Other Names 1

Other Name (5)Ma. Olivia Santos Roque Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ma. Olivia Roque San Diego Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Ma. Olivia San Diego reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
1,685 mi
Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1013433465 (877) 608-0044

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 60622 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

OLGA L SAAVEDRA M.D. SC
Clinic/Center (Primary Care)
1044 N MOZART ST, SUITE 503
CHICAGO, IL 60622
Cook County (773) 772-9607
KRISTEN RICHTER
Nurse Practitioner
1044 N MOZART ST, SUITE 100
CHICAGO, IL 60622
Cook County (773) 292-8300
DR. AUREA D PRIMERO
Family Medicine
1044 N MOZART ST, SUITE 505
CHICAGO, IL 60622
Cook County (773) 235-6047
BRIDGET ELIZABETH TYNER SAROYA CPNP
Nurse Practitioner (Pediatrics)
1044 N MOZART ST, STE-402
CHICAGO, IL 60622
Cook County (773) 292-4501
ALFREDO P. SY M.D.
Family Medicine
1044 N MOZART ST, SUITE 203
CHICAGO, IL 60622
Cook County (773) 292-8300
CHRISTINE NOWICKI LCSW
Social Worker (Clinical)
1044 N MOZART ST
CHICAGO, IL 60622
Cook County (773) 292-8300
DR. GEORGE THOMAS AMPALLOOR MD
Pediatrics
1044 N MOZART ST, SUITE 402
CHICAGO, IL 60622
Cook County (773) 292-4501
EDMUNDO RIOJA MD
Obstetrics & Gynecology
1044 N MOZART ST
CHICAGO, IL 60622
Cook County (773) 292-2600

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 Ma. Olivia San Diego's NPI number?

The NPI number for Ma. Olivia San Diego is 1285842997. It was assigned to this individual provider in the NPPES registry on May 18, 2007. The provider is also known as Ma. Olivia Santos Roque MD.

Where is Ma. Olivia San Diego located?

Ma. Olivia San Diego practices at 1044 N Mozart St Ste 205, Chicago, IL 60622. The listed phone number is (773) 489-2912.

What is Ma. Olivia San Diego's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Ma. Olivia San Diego enrolled in Medicare?

Yes. Ma. Olivia San Diego is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ma. Olivia San Diego's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ma. Olivia San Diego reassigns Medicare benefits to Southern California Permanente Medical Group (Hemet, CA). The 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 Ma. Olivia San Diego's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ma. Olivia San Diego was last updated on December 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.