Individual provider Active NPI

Rosalia Lopez de Alda

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1366025959
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14572 Issued in TX
Practice address
823 Congress Ave Ste 150-518
Austin, TX 78701-2405
Phone
(888) 380-0988
Fax
(289) 236-3022
NPI assigned
Apr 30, 2021
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14572 TX Primary

Addresses

Primary practice location

823 Congress Ave Ste 150-518
Austin, TX 78701-2405

Mailing address

2950 Buskirk Ave Ste 300
Walnut Creek, CA 94597-6900
Phone (888) 380-0988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210806001300 TX Practitioner - Physician Assistant 9537563911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14572TXMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1366025959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 BUSKIRK AVE STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945976900",
            "telephone_number": "888-380-0988",
            "fax_number": "289-236-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 CONGRESS AVE STE 150-518",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012405",
            "telephone_number": "888-380-0988",
            "fax_number": "289-236-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ DE ALDA",
        "first_name": "ROSALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.