Individual provider Active NPI

Clarines Rosa-de Jesus, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Tampa, FL
National Provider Identifier
1407029127
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
ME110997 Issued in FL
Practice address
3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone
(813) 971-6000
NPI assigned
Apr 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X ME110997 FL Primary
Pediatrics Physician 208000000X 25MA08374500 NJ
Pediatrics Physician 208000000X ME110997 FL
General Practice Physician 208D00000X ME110997 FL

Addresses

Primary practice location

3100 E Fletcher Ave
Tampa, FL 33613-4613

Mailing address

PO Box 5916
Tampa, FL 33675-5916
Phone (973) 444-7001

Other practice location 1

3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (786) 624-3741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120507000046 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5991967119 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110997FLMDPediatrics Physician
25MA08374500NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians-Heartland LLC CurrentSince Oct 1, 2024 Accepting new patients
Tampa Bay Emergency Physicians LLC CurrentSince Feb 8, 2021 Accepting new patients

Locations

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

Organizations & group practices 2

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": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1407029127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5916",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336755916",
            "telephone_number": "973-444-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-971-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331553009",
            "country_code": "US",
            "telephone_number": "786-624-3741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSA-DE JESUS",
        "first_name": "CLARINES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-03",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME110997",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08374500",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME110997",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME110997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.