Ronald Desrouilleres, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2024-01643 Issued in NC

Practice address

4105 Matthews Mint Hill Rd
Matthews, NC 28105-3633

Phone

(704) 316-3095

Fax

(704) 316-3096

NPI assigned

Mar 29, 2018

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NC2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rdesrouilleres1593064@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712

  Single Specialty

  Medicare reassignment NPD
• Comprehab LLC

  dba Compleat KiDZ Pediatric Therapy

  • Physical Therapist
  • Gastonia, NC
  • NPI 1407932775
  Care Compare group
• Novant Health Medical Group, LLC

  dba NHMG Primary Care Clinics

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517

  Single Specialty

  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640

  Single Specialty

  NPD (past)

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

• Novant Health Matthews Medical Center LLC

  dba Novant Health Matthews Medical Center

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation
• Novant Health Mint Hill Medical Center, LLC

  dba Novant Health Mint Hill Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1972001469
  Care Compare affiliation

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1285139410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 MATTHEWS MINT HILL RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281053633",
            "telephone_number": "704-316-3095",
            "fax_number": "704-316-3096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 River Rd",
            "address_purpose": "LOCATION",
            "city": "North Bergen",
            "state": "NJ",
            "postal_code": "070476217",
            "country_code": "US",
            "telephone_number": "201-854-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "462 Grider St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "14215",
            "country_code": "US",
            "telephone_number": "716-831-8612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2350 Ridgeway Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264127",
            "country_code": "US",
            "telephone_number": "585-922-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESROUILLERES",
        "first_name": "RONALD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "315392",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-01643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermatology Associates of Charlotte
• Neelam Vijay Desai, MD
• Sejal Shah Desai, PA
• Tanvi Naresh Desai
• Designer Solutions Care Homes
• Kerry Devereaux, M.S.P.T., CLT
• Jacqueline Devito, LCSWA
• Rajiv R Dewan, RPH
• Callie Ericson Dewese
• Savannah Deyton, LCSWA

• Family Medicine Physician in Matthews, NC
• Providers in Matthews, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.