David J Derosier Jr., ACNPC-AG, CPNP-AC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN269379 Issued in MA

Practice address

55 Lake Ave N
Pediatric Critical Care
Worcester, MA 01655-0002

Phone

(774) 442-2164

Fax

(774) 443-2062

NPI assigned

Jun 5, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Physicians of Massachusetts PCGroup PAC ID 4183038359, 84 clinicians

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent Hospital Hospital, Worcester, MA, CCN 220176

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dderosier66652@direct.bostonchildrens.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.

• Hospitalist Physicians of Massachusetts PC

  • Hospitalist Physician
  • Framingham, MA
  • NPI 1376145680

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group, Inc.

  dba Urgent Care Express at Harrington

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• VHS Acquisition Subsidiary Number 7 Inc

  dba Saint Vincent Hospital

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1538131214
  Care Compare affiliation

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1053935072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "PEDIATRIC CRITICAL CARE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-442-2164",
            "fax_number": "774-443-2062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "774-441-6468",
            "fax_number": "508-793-6315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "774-441-6468",
            "fax_number": "508-793-6315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEROSIER",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ACNPC-AG, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN269379",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN269379",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN269379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven James Derleth II
• Kathleen M. Dermady, CNM
• Jordan Elizabeth Dermody
• Kristen M Derosa, NNP-BC, ACNPC-AG
• Amanda Derosier, M.A
• Elaine C Derry-Neely, LSW
• Alicia Derry
• Rachel N Derry, F.N.P - B.C.
• Sarah E Derry, RD, LDN
• Mark Dershwitz, MD

• Acute Care Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Acute Care Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.