Thomas William Deroche, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601002637 Issued in MI

Practice address

7870W US Highway 2
Manistique, MI 49854-8992

Phone

(906) 341-3200

NPI assigned

Nov 29, 2006

Last updated

Aug 13, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/71812193-7aa5-42d8-ba4c-ee45e2ea853f/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bell Medical Center

  • Multi-Specialty Clinic/Center
  • Ishpeming, MI
  • NPI 1477664837
  NPD (past)
• Schoolcraft Memorial Hospital

  dba Schoolcraft Memorial HomeCare and Hospice

  • Home Health Agency
  • Manistique, MI
  • NPI 1447256276
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1467529735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROCHE",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Manistique
• Community Home Medical Inc (Curtis Family Pharmacy)
• Carole Louise Cooper, MSW, LBSW
• Ashley Couillard, MSN, RN, FNP
• Kyle Danks, PT, DPT
• Jason James Dougherty, L.M.S.W
• Christon Illia Dums, M.D.
• Allen Joseph Duyck, PT
• Heide Erickson
• Gabrielle Flatt, FNP

• Medical Physician Assistant in Manistique, MI
• Providers in Manistique, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.