Ivy Derosa, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS015851 Issued in PA

Practice address

104 Pheasant Run
Suite 123
Newtown, PA 18940-3439

Phone

(215) 702-8600

NPI assigned

Jun 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bucks County Dermaesthetics LLC

  • Procedural Dermatology Physician
  • Langhorne, PA
  • NPI 1558901025
  Medicare reassignment NPD Authorized official
• Pennsylvania Dermatology Partners Inc

  • Dermatology Physician
  • West Lawn, PA
  • NPI 1023382918
  Medicare reassignment NPD
• Rinklefree, LLC

  • Plastic Surgery Physician
  • Newtown, PA
  • NPI 1932557311
  Medicare reassignment NPD
• Steven R. Weasen

  • Specialist
  • Yardley, PA
  • NPI 1194760983
  NPD (past)

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1083935084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PHEASANT RUN",
            "address_2": "STE 123",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189403413",
            "telephone_number": "215-702-8600",
            "fax_number": "215-633-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PHEASANT RUN",
            "address_2": "SUITE 123",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189403439",
            "telephone_number": "215-702-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Floral Vale Blvd",
            "address_purpose": "LOCATION",
            "city": "Yardley",
            "state": "PA",
            "postal_code": "190675524",
            "country_code": "US",
            "telephone_number": "215-860-6100",
            "fax_number": "877-437-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "IVY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS015851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Dempsey
• Edward Bruce Denkin, DMD
• Dennis James Bonner, MD, LTD
• Dental Implant & Periodontal Surgeons, P.C.
• Christine Elizabeth Derosa, DPT
• Twisa Desai, MA, LPC, NCC
• Anil S Deshpande, M.D.
• Design for Vision Inc.
• Stephanie Desouza, MSW
• Meera Detroja

• Dermatology Physician in Newtown, PA
• Providers in Newtown, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.