Individual provider Active NPI

Laurence Dela Rosa, CRNA

  • Certified Registered Nurse Anesthetist
  • Baton Rouge, LA
National Provider Identifier
1447013271
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
30122 Issued in SC
Practice address
5220 Essen LN
Baton Rouge, LA 70809-3542
Phone
(225) 526-1971
NPI assigned
Feb 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 30122 SC Primary
Registered Nurse 163W00000X 858812 TX

Addresses

Primary practice location

5220 Essen LN
Baton Rouge, LA 70809-3542

Mailing address

4203 Glen CT
Pearland, TX 77584-3985
Phone (713) 550-3097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250423003125 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749706638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidelands Anesthesia Group LLCGroup PAC ID 5395258065, 51 clinicians

Practice addresses (Care Compare)

4070 Hwy 17
Suite 102
Murrells Inlet, SC 29576-5033
Phone (843) 652-1000

606 Black River Rd
Georgetown, SC 29440-3304
Phone (843) 527-7100

Hospital & facility affiliations

  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
858812TXMDRegistered Nurse
30122SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2025 Accepting new patients
Tidelands Anesthesia Group LLC CurrentSince Jul 21, 2025 Accepting new patients

Locations

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

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.

Hospital & facility affiliations 3

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1447013271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 GLEN CT",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775843985",
            "telephone_number": "713-550-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 ESSEN LN",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093542",
            "telephone_number": "225-526-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA ROSA",
        "first_name": "LAURENCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "30122",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "858812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.