Yudelka B De Los Santos, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00818900 Issued in NJ

Practice address

100 Medical Center Way
Somers Point, NJ 08244-2300

Phone

(609) 653-3265

NPI assigned

Sep 5, 2023

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Yudelka B Rodriguez Liria Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shore Specialty ConsultantsGroup PAC ID 1951613652, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shore Medical Center Hospital, Somers Point, NJ, CCN 310047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: yula.de.lo.santos.1@4024.direct.athenahealth.com

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.

• Shore Specialty Consultants

  • Multi-Specialty Clinic/Center
  • Somers Point, NJ
  • NPI 1962808519
  Medicare reassignment Care Compare group

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

• Shore Memorial Hospital

  • General Acute Care Hospital
  • Somers Point, NJ
  • NPI 1629070149
  Care Compare affiliation

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1740066737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 TULIP TREE PL",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083302831",
            "telephone_number": "609-277-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER WAY",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442300",
            "telephone_number": "609-653-3265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "649 Shore Rd",
            "address_purpose": "LOCATION",
            "city": "Somers Point",
            "state": "NJ",
            "postal_code": "082442449",
            "country_code": "US",
            "telephone_number": "609-365-3269 x1460",
            "fax_number": "609-601-7580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LOS SANTOS",
        "first_name": "YUDELKA",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00818900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YUDELKA",
            "last_name": "RODRIGUEZ LIRIA",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra K Dalton, DPM,,C.PEDORTHIST
• Frederick G Dalzell, MD
• Joshua Daniel, M.D.
• Thomas Patrick Darcy, R.PH.
• John Patrick Davis, LCSW, LCADC
• Isabelle Deal
• Peyton R Dearborn, M.D.
• Stacey Decore, LSW
• Maureen P Deely, RN
• Linda Mary Degrazia, APN

• Surgical Physician Assistant in Somers Point, NJ
• Providers in Somers Point, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.