NPIMap

Individual provider Active NPI

Joseph W Derosa

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1649205378
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21247 Issued in SC
Practice address
12 Arborland Way
Greenville, SC 29615-2201
Phone
(864) 297-6010
Fax
(864) 458-7673
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21247 SC Primary

Addresses

Primary practice location

12 Arborland Way
Greenville, SC 29615-2201

Mailing address

12 Arborland Way
Greenville, SC 29615-2201

Other identifiers 2

IdentifierTypeStateIssuer
T54394MedicaidSC
SCE5645193OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jderosa181075@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070115000230 SC Practitioner - Family Practice 7012917198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

12 Arborland Way
Greenville, SC 29615-2201
Phone (864) 297-6010

7221 S Pine St
Pacolet, SC 29372-3122
Phone (864) 474-1528

Hospital & facility affiliations

  • St Francis Hospital Home Care Home health agency, Simpsonville, SC, CCN 427049
  • Amedisys Home Health of Clinton Home health agency, Clinton, SC, CCN 427116
  • Centerwell Home Health Home health agency, Greenville, SC, CCN 427017
  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
  • Pelham Medical Center Hospital, Greer, SC, CCN 420103
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21247SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Feb 24, 2019 Accepting new patients
Spartanburg Medical Center CurrentSince Feb 24, 2019 Accepting new patients
Spartanburg Medical Center Family Medicine Current Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

12 Arborland Way
Greenville, SC 29615
Phone (864) 297-6010

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

7221 S Pine St
Pacolet, SC 29372
Phone (864) 474-1528

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: jderosa181075@direct-srhs.et0939.epichosted.com

Organizations & group practices 4

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1649205378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ARBORLAND WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ARBORLAND WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152201",
            "telephone_number": "864-297-6010",
            "fax_number": "864-458-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "JOSEPH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "21247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T54394",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE5645193",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jderosa181075@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jderosa181075@direct-srhs.et0939.epichosted.com",
            "address_1": "12 Arborland Way",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296152201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.