EDGARDO SOTO DE LA ROSA M.D.
NPI 1801030408
Internal Medicine - Pulmonary Disease in Port Charlotte, FL

Active since April 27, 2009PECOS EnrolledAccepts Medicare Assignment
98.78/100
CMS Quality Rating
4235 KINGS HWY, SUITE 103, PORT CHARLOTTE, FL 33980(941) 613-1777(941) 613-1779 Get Directions Write a Review

NPPES record last updated: June 27, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 27, 2017, Dec 19, 2016 (2 updates tracked since 2016).

About Edgardo Soto De La Rosa M.d. NPPES

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

EDGARDO SOTO DE LA ROSA M.D. (NPI 1801030408) is an individual pulmonary disease provider in Port Charlotte, Florida, licensed in Florida (115041) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with Shorepoint Health Port Charlotte, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1801030408
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameEDGARDO SOTO DE LA ROSACredential: M.D.
Location Address4235 KINGS HWY, SUITE 103Port Charlotte, FL 33980-8421
Mailing Address4235 Kings Hwy, Suite 103Port Charlotte, FL 33980-8421
Fax(941) 613-1779
Sole ProprietorYes
Medical School CMSOtherGraduated 2003
Enumeration DateApril 27, 2009
Last NPPES UpdateJune 27, 20172 updates tracked since enumeration
NPI 1801030408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in FL · 115041
Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 115041 (FL)
4235 KINGS HWY, Port Charlotte, FL 33980

Other Identifiers 3

Medicare PINHI041Y
Other14Q6ZFL · Bcbsfl
Medicaid009369200FL

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Edgardo Soto De La Rosa M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002953593
PECOS Enrollment IDI20130710000307
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 23

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
836 services528 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
570 services278 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
291 services87 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
241 services216 patients
Test to determine lung volumes using gas dilution or washout 94727
This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.
232 services222 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
232 services222 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Shorepoint Health Port Charlotte

Acute Care Hospitals · Port Charlotte, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100077
Location2500 Harbor BlvdPort Charlotte, FL 33952 · Charlotte County
Emergency services Birthing friendly

Sarasota Memorial Hospital

Acute Care Hospitals · Sarasota, FL
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100087
Location1700 S Tamiami TrlSarasota, FL 34239 · Sarasota County
Emergency services Birthing friendly

Desoto Memorial Hospital

Acute Care Hospitals · Arcadia, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100175
Location900 N Robert AveArcadia, FL 34265 · De Soto County
Emergency services

Hca Florida Fawcett Hospital

Acute Care Hospitals · Port Charlotte, FL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number100236
Location21298 Olean BlvdPort Charlotte, FL 33952 · Charlotte County
Emergency services

Hca Florida Englewood Hospital

Acute Care Hospitals · Englewood, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100267
Location700 Medical BlvdEnglewood, FL 34223 · Sarasota County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33980 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality89.24
Promoting Interoperability99
Improvement Activities40

Reported Quality Measures

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
45%22 patients3/55-star benchmark: 100%
Advance Care Plan
66%3,227 patients3/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
20%144 patients1/55-star benchmark: 87%
Controlling High Blood Pressure
77%256 patients4/55-star benchmark: 91%
Coronary Artery Disease (CAD): Antiplatelet Therapy
74%172 patients3/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%52 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
90%5,499 patients4/55-star benchmark: 100%
e-Prescribing
95%1,149 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%1,961 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
39%2,617 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
28%4,418 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 97% · 1,499 patients
Patients screened: 99% · 1,499 patients
83%206 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
75%1,826 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
86%418 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 2,024 patients
Patients totalRate: 1% · 2,026 patients
0%2,026 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 33

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
24 suppliers711 claims711 services$37.15 avg. paid by Medicare
Tracheostomy, inner cannula A4623
DME-Orthotic Devices · category DF000N
1 supplier12 claims371 services$5.83 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
5 suppliers51 claims96 services$1.37 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
5 suppliers13 claims13 services$12.45 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
17 suppliers420 claims420 services$87.78 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
16 suppliers421 claims1,218 services$34.25 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Pulmonary Disease)
4235 KINGS HWY, SUITE 103
PORT CHARLOTTE, FL 33980
Specialist
4235 KINGS HWY, SUITE 102
PORT CHARLOTTE, FL 33980
Psychiatry & Neurology (Neurology)
4235 KINGS HWY, SUITE 102
PORT CHARLOTTE, FL 33980
Internal Medicine (Pulmonary Disease)
4235 KINGS HWY, SUITE 103
PORT CHARLOTTE, FL 33980
Internal Medicine (Pulmonary Disease)
4235 KINGS HWY, STE 103
PORT CHARLOTTE, FL 33980
Dermatology
4235 KINGS HWY, SUITE 101
PUNTA GORDA, FL 33980

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 Edgardo Soto De La Rosa's NPI number?

The NPI number for Edgardo Soto De La Rosa is 1801030408. It was assigned to this individual provider in the NPPES registry on April 27, 2009.

Where is Edgardo Soto De La Rosa located?

Edgardo Soto De La Rosa practices at 4235 Kings Hwy Suite 103, Port Charlotte, FL 33980. The listed phone number is (941) 613-1777.

What is Edgardo Soto De La Rosa's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Edgardo Soto De La Rosa enrolled in Medicare?

Yes. Edgardo Soto De La Rosa is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edgardo Soto De La Rosa accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Edgardo Soto De La Rosa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edgardo Soto De La Rosa affiliated with any hospitals?

According to CMS data, Edgardo Soto De La Rosa is affiliated with Shorepoint Health Port Charlotte, Sarasota Memorial Hospital, Desoto Memorial Hospital, Hca Florida Fawcett Hospital and Hca Florida Englewood Hospital.

When was this NPI record last updated?

The NPPES record for Edgardo Soto De La Rosa was last updated on June 27, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.