NPIMap

Individual provider Active NPI

David Larosa Jr., M.D.

  • Internal Medicine Physician
  • Gulfport, MS
National Provider Identifier
1497860670
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16217 Issued in MS
Practice address
1340 Broad Ave
Suite 310
Gulfport, MS 39501-2404
Phone
(228) 864-6629
Fax
(228) 864-6669
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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 16217 MS Primary

Addresses

Primary practice location

1340 Broad Ave
Suite 310
Gulfport, MS 39501-2404

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 864-8454

Other identifiers 1

IdentifierTypeStateIssuer
00120612MedicaidMS

Other names 1

  • Dr. David Larosa Jr. Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080905000318 MS Practitioner - Internal Medicine 5991871519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Alabama College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians
Exceed Physical Therapy, LLCGroup PAC ID 8123378338, 72 clinicians

Practice addresses (Care Compare)

1202 Broad Ave
Gulfport, MS 39501-2426
Phone (228) 822-9360

12261 Hwy 49
Suite 1
Gulfport, MS 39503-2976
Phone (228) 265-7185

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2464

1340 Broad Ave
Gulfport, MS 39501-2465

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16217MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jul 1, 2008 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

1110 Broad Ave
Ste 700
Gulfport, MS 39501
Phone (228) 864-0314

1340 Broad Ave
Ste 310
Gulfport, MS 39501
Phone (228) 575-1400

12266 Ashley Dr
Gulfport, MS 39503
Phone (228) 225-4832

1612 31st Ave
Gulfport, MS 39501
Phone (228) 865-1453

5120 Beatline Rd
#A
Long Beach, MS 39560
Phone (228) 868-4287

Interoperability endpoints

  • Direct secure messaging: dlarosa@direct.mhg.com

Organizations & group practices 5

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 69

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1497860670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-864-8454",
            "fax_number": "228-865-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BROAD AVE",
            "address_2": "SUITE 310",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012404",
            "telephone_number": "228-864-6629",
            "fax_number": "228-864-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSA",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120612",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "LAROSA",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.