Armando V Depala Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A52324 Issued in CA

Practice address

1550 A Professional Drive
Petaluma, CA 94954

Phone

(707) 769-7403

Fax

(707) 769-0134

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Interoperability endpoints

• Direct secure messaging: adepala1763087@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Annadel Medical Group, Inc

  • Pediatrics Physician
  • Santa Rosa, CA
  • NPI 1114177425
  NPD (past)
• SRM Alliance Hospital Services

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1912938085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 A PROFESSIONAL DRIVE",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-769-7403",
            "fax_number": "707-769-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 A PROFESSIONAL DRIVE",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-769-7403",
            "fax_number": "707-769-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPALA",
        "first_name": "ARMANDO",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A52324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A523240",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adepala1763087@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "400 N McDowell Blvd",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949542339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adepala1763087@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1550 A Professional Drive",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caroline Denigris
• Stephen J Denigris, MD
• Stephen Denna
• Dennis M. McLeod, M.D., Inc
• Saloni A Deorukhkar, DPT, PT
• Candice Desbiens
• Alaknanda Devaskar, PT
• Diana Diaz, NP
• Alexander Michael Dibartolo
• Laurie A. Dibble, MD

• Pediatrics Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.