Michael Derose, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8319 Issued in WI

Practice address

3805B Spring St
Suite 320
Mount Pleasant, WI 53405-1641

Phone

(262) 687-2222

Fax

(262) 687-8611

NPI assigned

Aug 20, 2015

Sex

Male

Sole proprietor

No

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  WI

  Medicare reassignment Care Compare group NPD
• Ascension All Saints Hospital, Inc

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284

  WI

  Medicare reassignment NPD
• Ascension All Saints Hospital, Inc

  • Community/Retail Pharmacy
  • Mount Pleasant, WI
  • NPI 1164522132
  NPD
• Derose Family Counseling, LLC.

  • Community/Behavioral Health Agency
  • Racine, WI
  • NPI 1437423563
  NPD (past)

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

• Ascension All Saints Hospital, Inc

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284

  Hospital

  Care Compare affiliation

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ascension Medical Group-Southeast Wisconsin Inc 551 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 11, 2019.

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1295101574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805B SPRING ST STE 320",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805B SPRING ST",
            "address_2": "SUITE 320",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051641",
            "telephone_number": "262-687-2222",
            "fax_number": "262-687-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Health Professionals of Wisconsin, S.C.
• Dermatology Consultants LLC
• Developmental Disabilities Information Service, Inc.
• Yagya Dhakal, MD
• Diabetes Osteoporosis Thyroid Endocrine Center, LLC
• Amy Dimatteo, DC
• Vy Dinh, M.D.

• All providers in Mount Pleasant, WI
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.