Patrick A Derose, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0554631 Issued in NY

Practice address

980 Westfall Rd
BLDG 200, Suite 210
Rochester, NY 14618-2605

Phone

(585) 256-1500

Fax

(585) 256-1514

NPI assigned

Jul 19, 2006

Sex

Male

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 NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Progressive Endodontics LLC

  • Endodontics
  • Rochester, NY
  • NPI 1417008897
  NPD (past)
• Sci Anesthesia PLLC

  • Anesthesiology Physician
  • Rochester, NY
  • NPI 1316360126
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1386663193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 WESTFALL RD",
            "address_2": "BLDG 200, SUITE 210",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182605",
            "telephone_number": "585-256-1500",
            "fax_number": "585-256-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 WESTFALL RD",
            "address_2": "BLDG 200, SUITE 210",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182605",
            "telephone_number": "585-256-1500",
            "fax_number": "585-256-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "PATRICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-036813-L",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "0554631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Derooy
• Maria A Derosa, RPAC
• Tara A Derosa
• Thomas A Derosa, D.D.S.
• Angel Derose, CASAC
• Shannon Derose, RPA-C
• Martha Ellen Derosia, FNP
• Susan M Derrick, RN
• Michelle C Derue, OTD
• Victoria Derue, PNP

• Endodontics in Rochester, NY
• Providers in Rochester, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.