John P Derosa, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

205939 Issued in NY

Practice address

5645 Main St
Flushing, NY 11355-5045

Phone

(718) 670-1594

Fax

(718) 670-1901

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Diagnostic Radiology

Education

State University of New York at Stony Brook, School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Radiology at Bayside LLCGroup PAC ID 5395732671, 56 clinicians

Radiology Associates of Main Street PCGroup PAC ID 5799677522, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpd9006@direct.nyp.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.

• Main Street Radiology at Bayside LLC

  • Diagnostic Radiology Physician
  • Flushing, NY
  • NPI 1780771634
  Medicare reassignment Care Compare group NPD
• Radiology Associates of Main Street PC

  • Diagnostic Radiology Physician
  • Flushing, NY
  • NPI 1265529101
  Medicare reassignment Care Compare group NPD
• Sunset Park Radiology PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1629713672
  Medicare reassignment NPD
• Main Street Radiology at Bayside LLC

  • Diagnostic Radiology Physician
  • Jackson Heights, NY
  • NPI 1710395991
  NPD

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

• New York Hospital Queens Ambulance

  • Land Ambulance
  • Flushing, NY
  • NPI 1295857092

  Hospital

  Care Compare affiliation
• New York-Presbyterian-Queens

  • Clinical Medical Laboratory
  • Flushing, NY
  • NPI 1053429274

  Hospital

  Care Compare affiliation
• Newyork-Presbyterian-Queens

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1689958779

  Hospital

  Care Compare affiliation
• Newyork-Presbyterian-Queens

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1952347205
  Care Compare affiliation

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1124081302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 FRANCIS LEWIS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581922",
            "telephone_number": "718-352-9850",
            "fax_number": "718-352-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-1594",
            "fax_number": "718-670-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "205939",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "205939",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NY",
            "license": "205939",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "205939",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NY",
            "license": "205939",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "205939",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NY",
            "license": "205939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01824991",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.