Individual provider Active NPI

Robert T. Derosa, MD

  • Obstetrics & Gynecology Physician
  • Sylvania, OH
National Provider Identifier
1154320885
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35056097 Issued in OH
Practice address
5700 Monroe St
Suite 202
Sylvania, OH 43560-2767
Phone
(419) 473-6622
Fax
(419) 473-6627
NPI assigned
Jul 15, 2005
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35056097 OH Primary

Addresses

Primary practice location

5700 Monroe St
Suite 202
Sylvania, OH 43560-2767

Mailing address

1 Seagate
Suite 800
Toledo, OH 43604-1558
Phone (567) 585-1964

Other identifiers 6

IdentifierTypeStateIssuer
0786841MedicaidOH
00996OtherOHPARAMOUNT
ANTHEMOtherOH000000141262
160041509OtherOHRRMC
2083365OtherOHAETNA
07-01542OtherOHUHC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rderosa13495@epicdirect.promedica.org

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080620000392 OH Practitioner - Obstetrics/Gynecology 8820169741 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2130 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-4590

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

5700 Monroe St
Sylvania, OH 43560-2767
Phone (567) 585-0005

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35056097OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital CurrentSince Nov 27, 2010 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Promedica Central Physicians Obstetrics & Gynecology CurrentSince Apr 1, 1999 Accepting new patients
The Toledo Hospital CurrentSince Nov 27, 2010 Accepting new patients
Promedica Central Physicians CurrentSince Apr 1, 1999 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1601 Brigham Dr
Ste 160
Perrysburg, OH 43551
Phone (419) 872-7710

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

5700 Monroe St
Unit 303
Sylvania, OH 43560
Phone (419) 473-6622

5700 Monroe St
Unit 202
Sylvania, OH 43560
Phone (419) 473-6622

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

3740 W Sylvania Ave
Ste 103
Toledo, OH 43623
Phone (419) 473-6622

1 Seagate
Ste 800
Toledo, OH 43604

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: rderosa13495@direct.promedica.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1154320885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE",
            "address_2": "SUITE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "567-585-1964",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST",
            "address_2": "SUITE 202",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602767",
            "telephone_number": "419-473-6622",
            "fax_number": "419-473-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35056097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0786841",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "00996",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "000000141262",
            "identifier": "ANTHEM",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "160041509",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2083365",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "07-01542",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rderosa13495@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.