Individual provider Active NPI

Alicia Derobertis, M.D

  • Diagnostic Radiology Physician
  • Flushing, NY
National Provider Identifier
1588058630
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
299594 Issued in NY
Practice address
3225 Francis Lewis Blvd
Flushing, NY 11358-1922
Phone
(718) 428-1500
NPI assigned
Mar 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 299594 NY Primary

Addresses

Primary practice location

3225 Francis Lewis Blvd
Flushing, NY 11358-1922

Mailing address

3225 Francis Lewis Blvd
Flushing, NY 11358-1922
Phone (718) 428-1500

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505001913 NY Practitioner - Diagnostic Radiology 4981993102 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Main Street PCGroup PAC ID 5799677522, 52 clinicians
Main Street Radiology at Bayside LLCGroup PAC ID 5395732671, 56 clinicians
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians
Sunset Park Radiology PCGroup PAC ID 6608247291, 32 clinicians

Practice addresses (Care Compare)

2 Robbins Dr
East Williston, NY 11596-2008
Phone (718) 428-1500

21 Ivy Close
Forest Hills, NY 11375-6020
Phone (718) 670-1050

3225 Francis Lewis Blvd
Flushing, NY 11358-1922
Phone (718) 428-1500

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

5521 8TH Ave
FL 6
Brooklyn, NY 11220-3515
Phone (718) 928-2588

5645 Main St
Flushing, NY 11355-5045
Phone (718) 428-1500

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Feb 26, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Feb 26, 2024 Accepting new patients
Sunset Park Radiology PC Diagnostic Radiology CurrentSince Feb 20, 2024 Accepting new patients
Valley Physician Services PC CurrentSince Nov 1, 2025 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Feb 26, 2024 Accepting new patients
Radiology Associates of Main Street PC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Main Street Radiology at Bayside LLC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Oct 31, 2023 Accepting new patients
Columbia/Newyork-Presbyterian Advanced Imaging Inc. CurrentSince Nov 23, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

5521 8th Ave
Fl 6
Brooklyn, NY 11220
Phone (718) 928-2588

3225 Francis Lewis Blvd
Flushing, NY 11358
Phone 61421018851070

7206 Northern Blvd
Jackson Heights, NY 11372
Phone (718) 670-1512

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

630 W 168th St
#28
New York, NY 10032
Phone (212) 305-1948

51 W 51st St
Ste 300
New York, NY 10019
Phone (212) 342-3666

722 W 168th St
New York, NY 10032
Phone (212) 305-6754

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: ald9077@direct.nyp.org

Organizations & group practices 10

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1588058630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 FRANCIS LEWIS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581922",
            "telephone_number": "718-428-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 FRANCIS LEWIS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581922",
            "telephone_number": "718-428-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROBERTIS",
        "first_name": "ALICIA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "299594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.