Heidelene E De la Rosa, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C52214 Issued in CA

Practice address

16125 Kamana Rd
Apple Valley, CA 92307-1377

Phone

(760) 946-2600

Fax

(760) 946-5600

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GDBEAA/Endpoint/GDBEAA

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.

• Victor Valley Primary Care, Inc.

  • Clinic/Center
  • Apple Valley, CA
  • NPI 1487823985
  NPD
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1154378693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16125 KAMANA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071377",
            "telephone_number": "760-946-2600",
            "fax_number": "760-946-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16125 KAMANA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071377",
            "telephone_number": "760-946-2600",
            "fax_number": "760-946-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Stacey Burk Dr",
            "address_purpose": "LOCATION",
            "city": "Flora",
            "state": "IL",
            "postal_code": "628393241",
            "country_code": "US",
            "telephone_number": "618-662-2191",
            "fax_number": "618-662-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "HEIDELENE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036099009",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C52214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360990099",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154378693",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ECLINICALWORKS",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16125 Kamana Rd",
            "city": "Apple Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923071377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tory Day
• Benilda Ramos De Asis, M.D.
• Nancy Yvette De Dios
• Elizabeth De la Cruz
• Andres Gavino Alvarez De la Llana, MD
• Caryn De la Torre
• Regina Imelda Hojilla De Luna, M.D.
• Jacqueline De Santiago
• Lori Ann Dean, MPT
• Sedric Shawn Deason

• Pediatrics Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.