Active NPI
Peter G Derosa, M.D.
- Psychiatry Physician
- Barnstable, MA
National Provider Identifier
1285624510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 31245
- Practice address
- 275 Millway
Barnstable, MA 02630-1102 - Phone
- (508) 362-1363
- Fax
- (508) 362-1363
- NPI assigned
- Oct 27, 2005
- Last updated
- Dec 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 31245 | MA | Primary |
Addresses
Primary practice location
275 Millway
Barnstable, MA 02630-1102
Mailing address
275 Millway
PO Box 834
Barnstable, MA 02630-1102
Phone (508) 362-1363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197590400000",
"number": "1285624510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 MILLWAY",
"address_2": "PO BOX 834",
"city": "BARNSTABLE",
"state": "MA",
"postal_code": "026301102",
"telephone_number": "508-362-1363",
"fax_number": "508-362-1363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 MILLWAY",
"city": "BARNSTABLE",
"state": "MA",
"postal_code": "026301102",
"telephone_number": "508-362-1363",
"fax_number": "508-362-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROSA",
"first_name": "PETER",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-27",
"last_updated": "2007-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "31245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barnstable, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.