Individual provider Active NPI

Alfred Vincent De Rosa, MD

  • Internal Medicine Physician
  • Woodside, NY
National Provider Identifier
1477683480
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
143876 Issued in NY
Practice address
4844 44TH St
Woodside, NY 11377-6937
Phone
(718) 784-2834
Fax
(718) 784-2868
NPI assigned
Mar 7, 2007
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 143876 NY Primary

Addresses

Primary practice location

4844 44TH St
Woodside, NY 11377-6937

Mailing address

4844 44 St
Woodside, NY 11377
Phone (718) 784-2834

Other identifiers 1

IdentifierTypeStateIssuer
00816028MedicaidNY

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
I20051107000666 NY Practitioner - Internal MedicinePractitioner - Family Practice 4385662527 Practice locations: Woodside, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

48 -44
Woodside, NY 11377-6937

4844 44TH St
Woodside, NY 11377-6937
Phone (718) 784-2834

Merit-based Incentive Payment System (MIPS)

Final score
24.64 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
82.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ad Medical Care PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Big Apple Primary Medical Care PC Internal Medicine PastSince Jan 1, 2022 Accepting new patients

Locations

4844 44th St
Woodside, NY 11377
Phone (718) 404-8040

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, 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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1477683480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4844 44 ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "11377",
            "telephone_number": "718-784-2834",
            "fax_number": "718-784-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 44TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776937",
            "telephone_number": "718-784-2834",
            "fax_number": "718-784-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ROSA",
        "first_name": "ALFRED",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "143876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00816028",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.