Michael Derosa NP Adult Health PC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

MICHAEL DEROSA NP ADULT HEALTH PC

Practice address

314 E Main St
Smithtown, NY 11787-2901

Phone

(516) 983-3452

NPI assigned

Aug 16, 2022

Organization subpart

No

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

Authorized official

Name

Michael Derosa, NPNPI 1013971985

Title

President

Phone

(516) 983-3452

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Joseph Derosa, NP

  • Adult Health Nurse Practitioner
  • New York, NY
  • NPI 1013971985
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1831817824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRASSWOOD RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117803410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872901",
            "telephone_number": "516-983-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL DEROSA NP ADULT HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "DEROSA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-983-3452",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A. Meyer, OTR/CHT
• Robert H Meyer, PHD
• Joel L. Meyers, P.T., DPT
• Michael a Herships Psychologist, PC
• Michael Bishai MD, LLC
• Andreas Costas Michaelides, PH.D.
• Maria A. Michalski, O.D.
• Cristina Michelcic, SPECIAL ED TEACHER
• Michele Ahmadi D.P.M. L.L.C.
• Michelle Eckhoff, Marriage and Family Therapist, PLLC

• Adult Health Nurse Practitioner in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.