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SOP MEDICAL PC
NPI 1083805741
Clinic/Center - Primary Care in Corona, NY

Active since August 07, 2007CLIA 33D1084385 · Waiver
10211 ROOSEVELT AVE STE 4, CORONA, NY 11368(718) 898-1386(718) 898-1093 Get Directions Write a Review

NPPES record last updated: April 7, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sop Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOP MEDICAL PC (NPI 1083805741) is a healthcare organization registered as a primary care in Corona, New York and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists Hector Bienvenido Florimon De La Rosa, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1083805741
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSOP MEDICAL PC
Location Address10211 ROOSEVELT AVE STE 4Corona, NY 11368-2331
Mailing Address10211 Roosevelt Ave Ste 4Corona, NY 11368-2331 · (718) 898-1386 · Fax (718) 898-1093
Phone(718) 898-1386
Fax(718) 898-1093
Organization SubpartNo
Authorized OfficialHector Bienvenido Florimon De La RosaMedical Director · (718) 898-1386
Enumeration DateAugust 7, 2007
Last NPPES UpdateApril 7, 2021
NPPES CertifiedApril 7, 2021
✔ NPI 1083805741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
10211 ROOSEVELT AVE STE 4, Corona, NY 11368
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Other Identifiers 1

Medicaid02933219NY

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sop Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Sop Medical PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Roberto Moran, MD
Family Practice
NPI 1528550647
10211 ROOSEVELT AVE STE 4
Corona, NY 11368
(718) 898-1386
✔ PECOSSame address
Hector Florimon De La Rosa, M.D.
Pediatric Medicine
NPI 1649337858
102-11 ROOSEVELT AVE
Corona, NY 11368
(718) 898-5200
✔ PECOSSame address
Tatiana Gomez Lopez
Internal Medicine
NPI 1578947750
10211 ROOSEVELT AVE # 4
Corona, NY 11368
(718) 898-1386
✔ PECOSSame address
Glendalyz Alberto, MD
Internal Medicine
NPI 1366733719
701 E FM 1626 STE 100
Austin, TX 78748
(855) 481-8375
✔ PECOS✔ Accepts Medicare1,530 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1084385

Sop Medical PC · Corona, NY
Active · expires May 20, 2028
CLIA Number33D1084385
Laboratory TypePhysician Office
Certificate Effective DateMay 21, 2026
Certificate Expiration DateMay 20, 2028
Laboratory DirectorDr. Hector B. Florimon-Delarosa
Laboratory Phone(718) 898-1386
Laboratory LocationSop Medical PC102-11 Roosevelt Avenue Suite 4, Corona, NY 11368
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sop Medical PC's NPI number?

The NPI number for Sop Medical PC is 1083805741. It was assigned to this organization in the NPPES registry on August 7, 2007.

Where is Sop Medical PC located?

Sop Medical PC is located at 10211 Roosevelt Ave Ste 4, Corona, NY 11368. The listed phone number is (718) 898-1386.

What is Sop Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Sop Medical PC enrolled in Medicare?

Yes. Sop Medical PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sop Medical PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Sop Medical PC, in Family Practice, Internal Medicine and Pediatric Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Sop Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1084385) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sop Medical PC was last updated on April 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.