Individual provider Active NPI

Robin Derose, OTR,CHT,CVE

  • Hand Occupational Therapist
  • Van Nuys, CA
National Provider Identifier
1851414767
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT950 Issued in CA
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, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
954370043OtherCATAX ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

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.

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.

Verify at the official NPI Registry.