Individual provider Active NPI

Joseph Nicholas Deluca, MD, PHD

  • General Practice Physician
  • Altamonte Springs, FL
National Provider Identifier
1114930633
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME50155 Issued in FL
Practice address
378 Center Pointe Circle
Suite 1280
Altamonte Springs, FL 32701-3442
Phone
(407) 862-5959
Fax
(407) 774-5573
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0003384 FL
General Practice Physician 208D00000X ME0050155 FL
General Practice Physician 208D00000X ME50155 FL Primary

Addresses

Primary practice location

378 Center Pointe Circle
Suite 1280
Altamonte Springs, FL 32701-3442

Mailing address

378 Center Pointe Circle
Suite 1280
Altamonte Springs, FL 32701-3442
Phone (407) 862-5959

Other identifiers 1

IdentifierTypeStateIssuer
046585200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY0003384FLMDClinical Psychologist
ME0050155FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1114930633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 CENTER POINTE CIRCLE",
            "address_2": "SUITE 1280",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327013442",
            "telephone_number": "407-862-5959",
            "fax_number": "407-774-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 CENTER POINTE CIRCLE",
            "address_2": "SUITE 1280",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327013442",
            "telephone_number": "407-862-5959",
            "fax_number": "407-774-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "JOSEPH",
        "middle_name": "NICHOLAS",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003384",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0050155",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME50155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046585200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.