David Derosso, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN135847 Issued in GA

Practice address

1499 Fair Rd
Statesboro, GA 30458-1683

Phone

(704) 662-5544

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ams Southeast LLCGroup PAC ID 3870880792, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Medicare enrollment (NPD)

Enrolled

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.

• Ams Southeast LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1487107157

  GA, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• American Anesthesiology Associates of Georgia, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
  • NPI 1528068673
  Medicare reassignment NPD
• Synergy Anesthesiology Inc

  • Certified Registered Nurse Anesthetist
  • Alpharetta, GA
  • NPI 1003040502

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  NPD (past)

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

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1194897710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 3RD ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013357",
            "telephone_number": "478-633-6706",
            "fax_number": "478-633-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581683",
            "telephone_number": "704-662-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSSO",
        "first_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN135847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE",
            "identifier": "000932236B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000932236B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "344303",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00115347",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica B Debrah, RPH
• Brandon Michael Defeo, DPT
• Sreevalli Dega, MD
• Brian Mixon Deloach, M.D.
• Bralie Dent
• Nancy W. Derr, RN, IBCLC
• Donald Devine, LMT
• Susmita Dey, MPH
• Kristen Noel Dickens, PH.D., LPC, ACS, NCC
• Nicolle Maria Digerolamo-Thaller, APRN, BC

• Certified Registered Nurse Anesthetist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.