Individual provider Active NPI

Jesse Deluca, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Fort Belvoir, VA
National Provider Identifier
1083714323
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
0102202092 Issued in VA
Practice address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone
(571) 231-3224
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Family Medicine Physician 207Q00000X 0102202092 VA
Clinical Pharmacology Physician 208U00000X 0102202092 VA
Sports Medicine (Family Medicine) Physician 207QS0010X 0102202092 VA Primary

Addresses

Primary practice location

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Mailing address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone (571) 231-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100626000201 VA Practitioner - Family Practice 2264563808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rapidan Medical CenterGroup PAC ID 9739189010, 7 clinicians

Practice addresses (Care Compare)

4444 Germanna Hwy
Suite 310
Locust Grove, VA 22508-2039
Phone (540) 972-6222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102202092VAMDClinical Pharmacology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rapidan Medical Center CurrentSince May 1, 2026 Accepting new patients

Locations

4444 Germanna Hwy
Ste 310
Locust Grove, VA 22508
Phone (540) 972-6222

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1083714323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202092",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "VA",
            "license": "0102202092",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102202092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

Verify at the official NPI Registry.