Melissa Derboghossian, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

334140 Issued in NY

Practice address

300 Meridian Centre Blvd
Suite 320
Rochester, NY 14618-3981

Phone

(518) 469-1064

Fax

(585) 463-3105

NPI assigned

Mar 15, 2007

Last updated

Feb 27, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.medent.com/fhir/R4/gwT5767X

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.

• Lansingburgh Family Practice, PC

  • Family Medicine Physician
  • Troy, NY
  • NPI 1710931837
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1750415766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MERIDIAN CENTRE BLVD",
            "address_2": "SUITE 320",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183981",
            "telephone_number": "518-469-1064",
            "fax_number": "585-463-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MERIDIAN CENTRE BLVD",
            "address_2": "SUITE 320",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183981",
            "telephone_number": "518-469-1064",
            "fax_number": "585-463-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBOGHOSSIAN",
        "first_name": "MELISSA",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F33041-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "334140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dependable Medical Transportation
• Laura Deperrior
• Jordan T Depierro
• Kari Marie Depoint, NP
• Nicole M Depuyt, RN
• Rhaissa Derby, DO
• Edward A Derck, DOCTORATE OF PHARMAC
• Derden LLC
• Edie L Derian, M.D.
• Vincent Evan Derienzo, PA

• Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.