Individual provider Active NPI

Rodelle Ann N. De Vera, NP

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1164112041
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024513 Issued in CA
Practice address
470 Blossom Hill Rd
San Jose, CA 95123-3301
Phone
(408) 578-4900
NPI assigned
May 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95024513 CA Primary

Addresses

Primary practice location

470 Blossom Hill Rd
San Jose, CA 95123-3301

Mailing address

470 Blossom Hill Rd
San Jose, CA 95123-3301
Phone (408) 578-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230626000117 CA Practitioner - Nurse Practitioner 6800254764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infusion Express of California IncGroup PAC ID 2365720604, 24 clinicians

Practice addresses (Care Compare)

717 E Camino Real
Suite 5
Sunnyvale, CA 94087
Phone (408) 228-3700

Merit-based Incentive Payment System (MIPS)

Final score
76.8 of 100Reported as group
Quality
65.04
Improvement activities
40
Cost
86.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion Express of California Inc CurrentSince Feb 19, 2025 Accepting new patients

Locations

66 Bovet Rd
Ste 105
San Mateo, CA 94402
Phone (510) 992-4114

717 E El Camino Real
Ste 5
Sunnyvale, CA 94087
Phone (408) 228-3700

Interoperability endpoints

  • Direct secure messaging: rodelle.ann.de.vera.1@22091.direct.athenahealth.com

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": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1164112041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 BLOSSOM HILL RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233301",
            "telephone_number": "408-578-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 BLOSSOM HILL RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233301",
            "telephone_number": "408-578-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "RODELLE ANN",
        "middle_name": "N.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.