Individual ProviderRichard RocheInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address6701 Jefferson St NE, Albuquerque, NM 87109-4318(505) 727-6200PECOS EnrollmentBased on the most recent information from CMS, provider Richard Roche is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1821194937Provider TypeIndividualFull NameRoche, RichardCredentialMDGenderMaleSole ProprietorNoEnumeration Date9/15/2006Last Updated4/17/2017Contact InformationPractice LocationPractice Address6701 Jefferson St NE, Albuquerque, NM 87109-4318Phone(505) 727-6200Fax(505) 727-9590Mailing LocationMailing Address6701 Jefferson St NE, Albuquerque, NM 87109-4318Phone(505) 727-6200Fax(505) 727-9590Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense87-278New MexicoCode173000000XDescriptionLegal MedicineOther Service ProvidersLicense87278New MexicoProvider IdentifiersIDDescriptionIssuerIDH7486DescriptionMedicaidIssuerUnlistedNew Mexico