Pedro Alcantara De Andrade Filho, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

A126819 Issued in CA

Practice address

11175 Campus St Ste 11120
Loma Linda, CA 92350-1700

Phone

(909) 558-0440

NPI assigned

Apr 18, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Pedro Alcantara de Andrade Filho Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Medicare reassignment NPD
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  • NPI 1083863914
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1841580339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST STE 11120",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700",
            "telephone_number": "909-558-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST STE 11120",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700",
            "telephone_number": "909-558-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ANDRADE FILHO",
        "first_name": "PEDRO",
        "middle_name": "ALCANTARA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A126819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEDRO",
            "last_name": "ANDRADE FILHO",
            "middle_name": "ALCANTARA DE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Luther Eugene Davis, PH.D.
• Michael Keith Davis, OTR/L
• Sydney Davis
• Elizabeth Ann Davisson, F.N.P.
• Justin Daw
• John Sebastian De Armas
• Jessica Nicole De Brun, MOT, OTR/L
• Veronica De la Rosa
• Grace Fermina De Lara, RN-BC, BSN
• Irene Margaret Locsin De Leon, M.D.

• Otolaryngology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.