Individual provider Active NPI

Diane E. Deroos, SLP

  • Speech-Language Pathologist
  • Auburn, NY
National Provider Identifier
1063447142
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004387 Issued in NY
Practice address
182 North St
Auburn, NY 13021-1811
Phone
(315) 255-2746
Fax
(315) 255-2740
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 004387 NY Primary

Addresses

Primary practice location

182 North St
Auburn, NY 13021-1811

Mailing address

182 North St
Auburn, NY 13021-1811
Phone (315) 255-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190517000267 NY Practitioner - Qualified Speech Language Pathologist 3173866928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince May 5, 2025 Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

305 Main St
Binghamton, NY 13905
Phone (607) 729-1295

6007 Fair Lakes Rd
Ste 400
East Syracuse, NY 13057
Phone (315) 234-5730

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063447142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 NORTH ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211811",
            "telephone_number": "315-255-2746",
            "fax_number": "315-255-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 NORTH ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211811",
            "telephone_number": "315-255-2746",
            "fax_number": "315-255-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROOS",
        "first_name": "DIANE",
        "middle_name": "E.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "004387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.