Anie Sophia Derolus, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2348277 Issued in MA

Practice address

152 Wood Ave
Hyde Park, MA 02136-3857

Phone

(617) 953-6617

NPI assigned

Nov 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1306554068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 WOOD AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363857",
            "telephone_number": "617-953-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 WOOD AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363857",
            "telephone_number": "617-953-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROLUS",
        "first_name": "ANIE",
        "middle_name": "SOPHIA",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2348277",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2348277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Demello Egan, M.A., M.ED., LMHC
• Vanessa Denaud, RN
• Clarence T Dennis, PMHNP-BC
• Jaleesa Dennis
• Kianesha D Dennis
• Nehemie Desroches
• Destini Healthcare Services Inc.
• Valmeda Dickson, M.E.D, M.H.C
• Dignity Speech Services LLC
• Aslyn Dindorf, PT, DPT

• Family Nurse Practitioner in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.