Individual provider Active NPI

Robert Derosier, OT

  • Occupational Therapist
  • Blue Bell, PA
National Provider Identifier
1053841981
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC006662L Issued in PA
Practice address
1515 Dekalb Pike Ste 100
Blue Bell, PA 19422-3367
Phone
(610) 277-1990
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC006662L PA Primary

Addresses

Primary practice location

1515 Dekalb Pike Ste 100
Blue Bell, PA 19422-3367

Mailing address

1515 Dekalb Pike
Ste 204
Blue Bell, PA 19422-3367
Phone (610) 277-1990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC006662LPAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery County Hand Center Inc Occupational Therapist PastSince Jul 24, 2022 Accepting new patients
Montgomery County Hand Center PastSince May 1, 2017 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053841981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DEKALB PIKE",
            "address_2": "STE 204",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194223367",
            "telephone_number": "610-277-1990",
            "fax_number": "610-277-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DEKALB PIKE STE 100",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194223367",
            "telephone_number": "610-277-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIER",
        "first_name": "ROBERT",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC006662L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.