Antonio De Las Morenas, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2018-02510 Issued in NC

Practice address

670 Albany St
3Rd Floor
Boston, MA 02118-2518

Phone

(617) 414-5314

Fax

(617) 414-5315

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pathologists Diagnostic Laboratory PA

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1437424975
  NPD
• Evans Medical Foundation, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1912954124
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1184697492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 ALBANY ST",
            "address_2": "3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182518",
            "telephone_number": "617-414-5314",
            "fax_number": "617-414-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LAS MORENAS",
        "first_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2018-02510",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MA",
            "license": "53324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30204459",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3043398",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ignacio Israel De la Cruz, DMD
• Alejandro De la Hoz Gomez, MD
• David Jairo De la Hoz
• Ashley De la Osa
• Lauren Elizabeth De la Parte, MD
• Denise De Las Nueces, MD
• Danielle Marie De Latour, APRN
• Carrina De Leon
• Channel Marie De Leon, PHARMD
• Kiana Nataly De Leon

• Anatomic Pathology & Clinical Pathology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.