Individual provider Active NPI

Tara A Derosa

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1619603107
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349981 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 275-4711
NPI assigned
Jul 27, 2022
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 349981 NY Primary
Registered Nurse 163W00000X 717311 NY

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave Box Med
Rochester, NY 14642-0001
Phone (585) 275-4711

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823002416 NY Practitioner - Nurse Practitioner 5799168894 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
717311NYMDRegistered Nurse
349981NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Group CurrentSince Aug 29, 2022 Accepting new patients
University of Rochester CurrentSince Aug 29, 2022 Accepting new patients
U of R Anesthesiology Group CurrentSince May 16, 2023 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Aug 29, 2022 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
University of Rochester PastSince May 16, 2023 Accepting new patients

Locations

158 Sawgrass Dr
Rochester, NY 14620
Phone (585) 262-9150

158 Sawgrass Dr
Ste 100
Rochester, NY 14620
Phone (585) 262-9150

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#604
Rochester, NY 14642
Phone (585) 275-2141

601 Elmwood Ave
#684
Rochester, NY 14642
Phone (585) 784-9503

Interoperability endpoints

  • Direct secure messaging: tderosa107695@direct.urmc.rochester.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1619603107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX MED",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "TARA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-08-02",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349981",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "717311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.