Individual provider Active NPI

Shirley De la Rosa, OD

  • Optometrist
  • Orlando, FL
National Provider Identifier
1124300413
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5850 Issued in FL
Practice address
5020 E Colonial Dr
Orlando, FL 32803-4312
Phone
(321) 430-1266
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002476 VA
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OPC5850 FL Primary

Addresses

Primary practice location

5020 E Colonial Dr
Orlando, FL 32803-4312

Mailing address

7157 Narcoossee Rd # 1308
Orlando, FL 32822-5533
Phone (321) 430-1266

Other practice location 1

701 W Livingston St Bldg 800
Orlando, FL 32805-1535
Phone (407) 428-5751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, FL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200527002592 DC Practitioner - Optometry 7315368404 Reassigns benefits to 3 organizations
Practice locations: Alexandria, VA
I20200908002146 VA Practitioner - Optometry 7315368404 Reassigns benefits to 1 organization
I20210113000751 FL Practitioner - Optometry 7315368404 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5850FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Center for the Homeless Inc Current Accepting new patients
Sightrite Medical VA PLLC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
De la Rosa Eyecare, LLC Optometrist Current Accepting new patients
Health Care Center for the Homeless, Inc. CurrentSince Jan 7, 2024 Accepting new patients
Health Care Center for the Homeless, Inc. CurrentSince Jan 7, 2024 Accepting new patients
Sightrite Medical DC PLLC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jan 4, 2021 Accepting new patients
Health Care Center for the Homeless Inc Past Accepting new patients

Locations

2425 25th St SE
Washington, DC 20020
Phone (202) 678-0013

12950 E Colonial Dr
Ste 100
Orlando, FL 32826
Phone (352) 361-5205

4426 Old Winter Garden Rd
Orlando, FL 32811
Phone (407) 428-1672

5020 E Colonial Dr
Orlando, FL 32803
Phone (321) 430-1266

232 N Orange Blossom Trl
Orlando, FL 32805
Phone (407) 428-1672

701 W Livingston St
Bldg 800
Orlando, FL 32805

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

107 S West St
Alexandria, VA 22314
Phone (571) 305-0400

10701 Main St
Fairfax, VA 22030
Phone (703) 273-7705

1776 Cambridge Dr
Richmond, VA 23238
Phone (804) 368-6474

Organizations & group practices 11

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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1124300413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7157 NARCOOSSEE RD # 1308",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328225533",
            "telephone_number": "321-430-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034312",
            "telephone_number": "321-430-1266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Livingston St Bldg 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328051535",
            "country_code": "US",
            "telephone_number": "407-428-5751",
            "fax_number": "407-428-6204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002476",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.