Individual provider Active NPI

Herbert Del Rosario Icasiano, DO

  • Emergency Medicine Physician
  • Los Alamitos, CA
National Provider Identifier
1740772383
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
19631 Issued in CA
Practice address
3751 Katella Ave
Los Alamitos, CA 90720-3113
Phone
(562) 598-1311
NPI assigned
May 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 19631 CA Primary
Emergency Medicine Physician 207P00000X OS020260 PA

Addresses

Primary practice location

3751 Katella Ave
Los Alamitos, CA 90720-3113

Mailing address

219 N Main Ave Unit 140
Scranton, PA 18504-3307
Phone (401) 569-8680

Other practice location 1

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-6333

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221118001291 CA Practitioner - Emergency Medicine 5092046573 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
William Carey University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University ofGroup PAC ID 7517869605, 126 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS020260PAMDEmergency Medicine Physician
19631CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 26, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 26, 2024 Accepting new patients
Regents of the University of Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
University of California Irvine Past Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

3700 South St
Lakewood, CA 90712
Phone (562) 424-2900

3751 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-3160

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Organizations & group practices 8

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1740772383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N MAIN AVE UNIT 140",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185043307",
            "telephone_number": "401-569-8680",
            "fax_number": "401-561-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203113",
            "telephone_number": "562-598-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 E Main St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109402650",
            "country_code": "US",
            "telephone_number": "845-333-6333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICASIANO",
        "first_name": "HERBERT",
        "middle_name": "DEL ROSARIO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "19631",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS020260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.