Individual provider Active NPI

Brian De la Rosa, M.D.

  • Emergency Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1235276197
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
040558 Issued in CT
Practice address
2800 Main St
St. Vincents Medical Center
Bridgeport, CT 06606-4201
Phone
(203) 576-5177
NPI assigned
Jan 31, 2007
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 040558 CT Primary

Addresses

Primary practice location

2800 Main St
St. Vincents Medical Center
Bridgeport, CT 06606-4201

Mailing address

2800 Main St
St. Vincents Medical Center
Bridgeport, CT 06606-4201
Phone (203) 576-5177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100114000292 CT Practitioner - Emergency Medicine 4789725649 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2800 Main St
Bridgeport, CT 06606-4201
Phone (475) 210-5242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040558CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Dec 1, 2020 Accepting new patients
Neighborhood Health, Inc. Emergency Medicine CurrentSince Jan 1, 2010 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

2720 Main St
Ste 1
Bridgeport, CT 06606

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

1055 Post Rd
Fairfield, CT 06824
Phone (203) 254-1055

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: brian.delarosa@xdr.hhchealthdirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1235276197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "address_2": "ST. VINCENTS MEDICAL CENTER",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "address_2": "ST. VINCENTS MEDICAL CENTER",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "040558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.