Individual provider Active NPI

Deborah Sue De la Rosa, CPNP

  • Pediatric Nurse Practitioner
  • Edinburg, TX
National Provider Identifier
1467665174
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
462448 Issued in TX
Practice address
5007 S McColl Rd
Edinburg, TX 78539-8080
Phone
(956) 587-0555
Fax
(956) 587-0550
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 462448 TX Primary

Addresses

Primary practice location

5007 S McColl Rd
Edinburg, TX 78539-8080

Mailing address

5007 S McColl Rd
Edinburg, TX 78539-8080
Phone (956) 587-0555

Other practice location 1

2112 E Griffin Pkwy
Mission, TX 78572-3225
Phone (956) 904-2202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
462448TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Kids Care, P.a. Pediatrics Past Accepting new patients
Advanced Kids Care 2, P.a. Pediatrics PastSince Aug 1, 2020 Accepting new patients

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1467665174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398080",
            "telephone_number": "956-587-0555",
            "fax_number": "956-587-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5007 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398080",
            "telephone_number": "956-587-0555",
            "fax_number": "956-587-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2112 E Griffin Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "TX",
            "postal_code": "785723225",
            "country_code": "US",
            "telephone_number": "956-904-2202",
            "fax_number": "956-904-2204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "DEBORAH",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "462448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.