Donna Lynn Derose, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209015563 Issued in IL

Practice address

145 S Virginia St
Crystal Lake, IL 60014-7226

Phone

(815) 444-9999

NPI assigned

Apr 18, 2017

Last updated

Apr 18, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

FJ Psychological ServicesGroup PAC ID 7315344587, 2 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• FJ Psychological Services

  • Clinical Psychologist
  • Volo, IL
  • NPI 1730606575
  Medicare reassignment Care Compare group NPD
• Main St. Psychiatry, S.C.

  • Psychiatry Physician
  • Cary, IL
  • NPI 1346756491
  Medicare reassignment NPD
• Montes Psychiatric Center, P.C.

  • Psychiatry Physician
  • Rockford, IL
  • NPI 1629694278
  NPD
• Mercy Health System Corporation

  dba Mercy Walworth Hospital and Medical Center

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD (past)

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1285168120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8802 REESE RD",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600339125",
            "telephone_number": "815-600-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147226",
            "telephone_number": "815-444-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209015563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christina M Deroo, MOT, OTR/L
• Nikul Desai, DPT
• Ali M Dia, D.C.
• Diabetic Footwear Solutuions LLC
• Amanda Marie Diamond, PA-C
• Tania Diaz

• Psychiatric/Mental Health Nurse Practitioner in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.