Demetrios Roussos, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

381829 Issued in NY

Practice address

301 E 17TH St
New York, NY 10003-3804

Phone

(212) 598-6286

NPI assigned

Nov 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Nurse Practitioner

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1356522908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-598-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-598-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSOS",
        "first_name": "DEMETRIOS",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-23",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "droussos39318@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "301 E 17th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100033804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew H Rouse, PHD
• Mia Jocelyn Rouse
• George C Roush, MD
• Anne Rousselot, LCSW
• June Carol Rousso, PH.D.
• Panagiotis Roussos, M.D., PH.D.
• Polina Roustamov
• Emma Routhier, PH.D.
• Madeline Elizabeth Rouverol
• Madeleine Rouviere

• Pediatric Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.