Active NPI
Roxana Gilda De la Rosa, O.D.
- Optometrist
- Los Angeles, CA
National Provider Identifier
1003048588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 13835
- Practice address
- 105 1/2 S Vermont Ave
Los Angeles, CA 90004-5904 - Phone
- (213) 383-8036
- NPI assigned
- Aug 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 13835 | CA | Primary |
Addresses
Primary practice location
105 1/2 S Vermont Ave
Los Angeles, CA 90004-5904
Mailing address
1652 S Berendo St
Los Angeles, CA 90006-4411
Phone (323) 734-5307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091104000426 | CA | Practitioner - Optometry | 6204974686 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| De la Rosa Family Vision, PC | Optometrist | Current | Accepting new patients |
| Optometric Eye Institute PC | Optometrist | Past | Accepting new patients |
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Locations
105 S Vermont Ave
#1-2
Los Angeles, CA 90004
Phone (213) 383-8036
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Los Angeles, CA
- NPI 1902561491
-
- Eyewear Supplier
- Riverside, CA
- NPI 1366598120
-
- Optometrist
- Los Angeles, CA
- NPI 1306025390
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364860800000",
"number": "1003048588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1652 S BERENDO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900064411",
"telephone_number": "323-734-5307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 1/2 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900045904",
"telephone_number": "213-383-8036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA ROSA",
"first_name": "ROXANA",
"middle_name": "GILDA",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-17",
"last_updated": "2013-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.