Carlos Alberto De la Rosa, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV005619 Issued in NY

Practice address

3777 Broadway
New York, NY 10032-1541

Phone

(212) 926-0336

Fax

(212) 926-0212

NPI assigned

Mar 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Leslie E. Gordon, MD P.C.

  • Cornea and External Diseases Specialist Physician
  • Bronx, NY
  • NPI 1285230722
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1487623112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 HERRICK AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "212-926-0336",
            "fax_number": "212-926-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321541",
            "telephone_number": "212-926-0336",
            "fax_number": "212-926-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "CARLOS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00534900",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3087018",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01759824",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eneil Ryan De la Pena, ANP-BC, GNP
• Rocio De la Rosa Campos, LAC
• Anna M De la Rosa, LCSW
• April De la Rosa, CRNA
• Ashanti De la Rosa
• Cynthia Orisel De la Rosa
• Edita De la Rosa
• Nila Theresa De la Rosa, MSN, RN, NP-C, OCN
• Alexandra Anita De la Rua, OTR/L
• Natalia De la Vega Martinez

• Optometrist in New York, NY
• Providers in New York, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.