Dallas Joseph De la Vara, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A175169 Issued in CA

Practice address

101 The City Dr S
Orange, CA 92868-3201

Phone

(714) 456-8888

NPI assigned

Jun 29, 2018

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of Claifornia Univ NeursciencesGroup PAC ID 2769476357, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score

47.54 of 100Reported as apm

Quality

38.49

Promoting interoperability

0

Improvement activities

40

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.

• Regents of the University of Claifornia Univ Neursciences

  • Neurology Physician
  • Orange, CA
  • NPI 1205884210
  Medicare reassignment Care Compare group NPD

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

• University of California Irvine

  • Urgent Care Clinic/Center
  • Irvine, CA
  • NPI 1518739309

  Hospital

  Care Compare affiliation
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  Care Compare affiliation

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1235624321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "714-456-8888",
            "fax_number": "352-273-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326081134",
            "country_code": "US",
            "telephone_number": "352-265-8408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3009 SW Williston Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326083928",
            "country_code": "US",
            "telephone_number": "352-294-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326105317",
            "country_code": "US",
            "telephone_number": "352-273-5550",
            "fax_number": "352-273-5575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA VARA",
        "first_name": "DALLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME158555",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A175169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie De la Rosa
• Joseph De la Rosa
• Francisco Roberto De la Serna, LMFT
• Nataly De la Torre
• Reynol De la Torre
• David De la Vega
• Lucia De la Vega
• Jorge De Leon Mendia
• Ingrid De Leon
• Justin Almacen De Leon

• Neurology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.