Individual provider Active NPI

Rachelle Beatrice De la Fuente, MD

  • Internal Medicine Physician
  • Queens, NY
National Provider Identifier
1467536862
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243246 Issued in NY
Practice address
82-68, 164TH Street
Queens Hospital Center
Queens, NY 11432
Phone
(718) 883-3000
Fax
(718) 883-6124
NPI assigned
Oct 24, 2006
Last updated
Sep 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 243246 NY Primary

Addresses

Primary practice location

82-68, 164TH Street
Queens Hospital Center
Queens, NY 11432

Mailing address

1226 Estates LN
Bayside, NY 11360-1140
Phone (718) 428-8920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060110000995 NY Practitioner - HospitalistPractitioner - Internal Medicine 5496778938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 562-6385

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as individual
Quality
98.74
Improvement activities
0
Cost
83.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Suffolk Medical, P.C. CurrentSince Jan 1, 2016 Accepting new patients
Southwest Suffolk Medical PC CurrentSince Jan 1, 2016 Accepting new patients
St. Francis Hospital Past Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21626/brand/2/csg/1/fhir/r4

Organizations & group practices 4

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1467536862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 ESTATES LN",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601140",
            "telephone_number": "718-428-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82-68, 164TH STREET",
            "address_2": "QUEENS HOSPITAL CENTER",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-883-3000",
            "fax_number": "718-883-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA FUENTE",
        "first_name": "RACHELLE",
        "middle_name": "BEATRICE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "243246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens, NY

Sources for this page

Verify at the official NPI Registry.