Michael A Derosa, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

033954 Issued in GA

Practice address

2347 Lenora Church Rd
Snellville, GA 30078-3232

Phone

(770) 979-2020

Fax

(770) 978-3321

NPI assigned

Nov 3, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Richard Carlin MD PC

  • Specialist
  • Snellville, GA
  • NPI 1538364815
  Medicare reassignment NPD

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1275524662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 LENORA CHURCH RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783232",
            "telephone_number": "770-979-2020",
            "fax_number": "770-978-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 LENORA CHURCH RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783232",
            "telephone_number": "770-979-2020",
            "fax_number": "770-978-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "033954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00475098A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Earl Delk, NP
• Arlevia Paschal Deloach-Wallace, LPC
• Evelyn Ahiante Dennis
• Kaniel Oniesha Dennis, PMHNP-BC
• Dental Safari LTD
• Roopa M Desai, PT
• Myrlene Desrosiers, FNP
• Destiny Adult Home Day Care
• Gabrielle Deverteuil
• Gamel Dewese, THERAPIST

• Ophthalmology Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.