Individual provider Active NPI

Stephen F Derose, M.D., M.S.H.S.

  • Sleep Medicine (Internal Medicine) Physician
  • Springfield, MA
National Provider Identifier
1710272810
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
279189 Issued in MA
Practice address
3300 Main St
3Rd FL, Suite C&D
Springfield, MA 01107-1112
Phone
(413) 794-5600
Fax
(413) 794-7297
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 279189 MA Primary

Addresses

Primary practice location

3300 Main St
3Rd FL, Suite C&D
Springfield, MA 01107-1112

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84756CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1710272810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN ST",
            "address_2": "3RD FL, SUITE C&D",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-5600",
            "fax_number": "413-794-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "STEPHEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.H.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MA",
            "license": "279189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.