Amanda R Derosa, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7738 Issued in AZ

Practice address

1072 E Old Canyon CT
Flagstaff, AZ 86001-6006

Phone

(928) 220-7504

NPI assigned

Jul 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Elevated Physical Therapy and Movement

  • Physical Therapist
  • Flagstaff, AZ
  • NPI 1215612627
  NPD Authorized official
• On Point Physical Therapy

  • Physical Therapist
  • San Diego, CA
  • NPI 1487133658
  NPD Authorized official
• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1134319700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 E OLD CANYON CT",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860016006",
            "telephone_number": "928-607-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 E OLD CANYON CT",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860016006",
            "telephone_number": "928-220-7504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 N TURQUOISE DR",
            "address_2": "STE 220",
            "address_purpose": "LOCATION",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012000",
            "country_code": "US",
            "telephone_number": "520-321-0204",
            "fax_number": "866-281-9515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "7738",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": "7738",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00432914",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denova Collaborative Health, LLC
• Dentists of Flagstaff, LLP
• Lakyn Laurel Denton
• Paige Alexandra Deremer-Young, DO, MPH
• Derosa Physical Therapy PC
• Carl Peter Derosa, PT
• Anthony Desjardins, MS, CCP
• Paul Despres, NMD
• George Destefano, RN
• Heather Lynn Devilliers, LPC

• Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.