Olaf Deroos, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3897 Issued in CO

Practice address

4150 Darley Ave Ste 8
Boulder, CO 80305-6537

Phone

(303) 494-4100

Fax

(303) 494-0212

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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.

• Active Solutions Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Boulder, CO
  • NPI 1013940808

  CO

  Medicare reassignment Care Compare group NPD Authorized official

Specialty

Physical Therapist in Private Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Solutions Physical Therapy, P.C. 3 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2008.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1730213752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21150",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803084150",
            "telephone_number": "303-546-9158",
            "fax_number": "303-546-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DARLEY AVE STE 8",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056537",
            "telephone_number": "303-494-4100",
            "fax_number": "303-494-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROOS",
        "first_name": "OLAF",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "3897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denver Recovery Group LLC
• Denver Recovery Group LLC
• Lindsey Iris Deol, DDS
• Zach Depledge
• Chantal Deroos, DPT
• Mary Kathrine Derrick, PT, DPT
• Nicolas Desmet, LMT
• Desmond Cohen Counseling LLC
• Diana Michele Desposito, MSW LCSW
• Shannon Quirk Detty, M.D.

• All providers in Boulder, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.