Jessica Derosa, AGNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2261788 Issued in MA

Practice address

800 Washington St
Boston, MA 02111-1552

Phone

(617) 636-2642

Fax

(617) 636-4599

NPI assigned

Jul 29, 2019

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiovascular Center at Tufts Medical Center IncGroup PAC ID 3870857816, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tufts Medical Center Hospital, Boston, MA, CCN 220116

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jderosa23994@tuftsmedicine.direct-ci.com

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.

• Cardiovascular Center at Tufts Medical Center, Inc.

  • Cardiovascular Disease Physician
  • Boston, MA
  • NPI 1447764253

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

• Tufts Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1497309447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-2642",
            "fax_number": "617-636-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "AGNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2261788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britney Jean Deroehn
• Jean M Deroo, RN
• Derosa Facial Plastic Surgery PC
• Alexandra Derosa, PA-C
• Jaimie Derosa, M.D.
• Nancy Marie Derosa, NP
• Erin R Derose, M.D.
• Mary Kathleen Derosia, OTR L
• Emily Alice Derosier
• Genevieve Derr, LMHC

• Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.