Active NPI
Robin Derose, OTR,CHT,CVE
- Hand Occupational Therapist
- Van Nuys, CA
National Provider Identifier
1851414767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- OT950
- Practice address
- 7120 Hayvenhurst Ave Ste 215
Van Nuys, CA 91406-3813 - Phone
- (818) 785-9515
- Fax
- (818) 785-9535
- NPI assigned
- Apr 6, 2007
- Last updated
- Jun 11, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | OT950 | CA | Primary |
Addresses
Primary practice location
7120 Hayvenhurst Ave Ste 215
Van Nuys, CA 91406-3813
Mailing address
7120 Hayvenhurst Ave Ste 215
Van Nuys, CA 91406-3813
Phone (818) 785-9515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 954370043 | Other | CA | TAX ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930003597 | CA | DME Supplier - Independently-Practicing Occupational Therapist | 4385718527 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Van Nuys, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Hand Occupational Therapist
- Van Nuys, CA
- NPI 1396868212
O20100930003597
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 2
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.
-
- Hand Occupational Therapist
- Van Nuys, CA
- NPI 1396868212
-
- Hand Occupational Therapist
- Canoga Park, CA
- NPI 1740422765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1851414767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7120 HAYVENHURST AVE STE 215",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063813",
"telephone_number": "818-785-9515",
"fax_number": "818-785-9535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7120 HAYVENHURST AVE STE 215",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063813",
"telephone_number": "818-785-9515",
"fax_number": "818-785-9535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROSE",
"first_name": "ROBIN",
"name_prefix": "Ms.",
"credential": "OTR,CHT,CVE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "CA",
"license": "OT950",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "954370043",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.