Individual provider Active NPI

Manuel Delarosa, MD

  • Emergency Medicine Physician
  • Lawton, OK
National Provider Identifier
1104833201
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21197 Issued in OK
Practice address
20 NW 67TH St
Suite E
Lawton, OK 73505-5630
Phone
(580) 536-9400
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21197 OK Primary

Addresses

Primary practice location

20 NW 67TH St
Suite E
Lawton, OK 73505-5630

Mailing address

20 NW 67TH St
Suite E
Lawton, OK 73505-5630
Phone (580) 536-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20051114000143 OK Practitioner - Emergency Medicine 7911926506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Xgto Urgent Medical of Lawton, LLCGroup PAC ID 4789863267, 3 clinicians

Practice addresses (Care Compare)

1902 E Gore Blvd
Lawton, OK 73501-6102
Phone (580) 357-4200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21197OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Xgto Urgent Medical of Lawton, LLC CurrentSince Jun 22, 2010 Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Memorial Health University Medical Center, Inc. Past Accepting new patients
Four States Emergency Physicians Emergency Medicine Past Accepting new patients
Swallowtail Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Physicians of North Texas PLLC Emergency Medicine Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine Past Accepting new patients
Wichita Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1902 E Gore Blvd
Lawton, OK 73501
Phone (580) 357-4200

Organizations & group practices 9

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1104833201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NW 67TH ST",
            "address_2": "SUITE E",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055630",
            "telephone_number": "580-536-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NW 67TH ST",
            "address_2": "SUITE E",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055630",
            "telephone_number": "580-536-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAROSA",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "21197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.