Brad Deroma

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LIAC-155343 Issued in AZ

Practice address

15815 S Lakewood Pkwy W Apt 2016
Phoenix, AZ 85048-7291

Phone

(760) 613-6861

NPI assigned

Jul 27, 2021

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Scottsdale Recovery II, LLC

  dba Scottsdale Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Scottsdale, AZ
  • NPI 1093278277
  NPD (past)
• Scottsdale Recovery II, LLC

  dba Scottsdale Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Scottsdale, AZ
  • NPI 1366905549
  NPD (past)
• Scottsdale Recovery II, LLC

  dba Scottsdale Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Scottsdale, AZ
  • NPI 1558824730
  NPD (past)
• Scottsdale Recovery II, LLC

  dba Scottsdale Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Scottsdale, AZ
  • NPI 1568085215
  NPD (past)

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1902579998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15815 S LAKEWOOD PKWY W APT 2119",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487294",
            "telephone_number": "760-613-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15815 S LAKEWOOD PKWY W APT 2016",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487291",
            "telephone_number": "760-613-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROMA",
        "first_name": "BRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-27",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-155343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermal Wellness Group LLC
• Dermatology Associates, P.C.
• Dermatology Clinic LTD
• Dermatology Vein and Laser Institute LLC
• Darrell James Dern, M.S., CCC-SLP
• Parker Constantine Deroo
• Gael Derouin, DO
• Pamela Louise Derouin, MD
• Derrick S. Hines M.D. P.C.
• Derrick Umphlett MD PC

• Addiction (Substance Use Disorder) Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.