Deana Marie Theroux, MD

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

235054 Issued in MA

Practice address

795 Middle St
Fall River, MA 02721-1733

Phone

(508) 235-5285

Fax

(508) 678-6905

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Warren Alpert Medical School of Brown University, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Lifespan Physician Group of Massachusetts Inc 458 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: deana.theroux.2@2017.direct.athenahealth.com
• Direct secure messaging: deana.theroux.4@2017.direct.athenahealth.com

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.

• Lifespan Physician Group of Massachusetts Inc

  • Family Medicine Physician
  • Taunton, MA
  • NPI 1235957713

  MA, Pediatrics

  Medicare reassignment Care Compare group NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219

  MA

  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Revere Medical of Massachusetts, PC

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1336976539
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1134200033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 MIDDLE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027211733",
            "telephone_number": "508-235-5285",
            "fax_number": "508-678-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 MIDDLE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027211733",
            "telephone_number": "508-235-5285",
            "fax_number": "508-678-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEROUX",
        "first_name": "DEANA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2003-00716",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "MA",
            "license": "235054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891347G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Stop & Shop Supermarket Company, LLC
• The Stop & Shop Supermarket Company, LLC
• Kerline Theodore
• Mark Francis Theodore, MA, LSW
• Therapy Resources Management, LLC
• Marc A Theroux, MD
• Angela Jean Therrien, LMHC, LADC1
• Didi Pathak Theva, M.D.
• Phylicia Lee Thibeault
• Larry F Thiesen, MD

• All providers in Fall River, MA
• Developmental - Behavioral Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.