Samantha Deriso, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

295075 Issued in NY

Practice address

1477 Hylan Blvd
Staten Island, NY 10305-1906

Phone

(718) 979-6900

NPI assigned

May 28, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Homemakers of Staten Island, Inc.

  • Home Health Agency
  • Staten Island, NY
  • NPI 1952462806
  NPD (past)

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1790910131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 ADAMS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065216",
            "telephone_number": "917-495-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051906",
            "telephone_number": "718-979-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERISO",
        "first_name": "SAMANTHA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "295075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Jennifer Depirro - Paolicelli, MS
• Donna Mae Depola, CASAC, CPP
• Dept of Education,Nyc
• Dean Joseph Derenzo, LMHC
• Patrick Anthony Derespinis Sr., M.D.
• Jenna Nicole Derleth, OT
• Denise Derosa, PT
• Ericka Derose
• Jelani Charles Derrick, RN
• Angel Deruvo, SLP MA CCC

• Licensed Practical Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.