Active NPI
Melissa M Derosa, MD
- Neurology Physician
- Carmel, IN
National Provider Identifier
1942416250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 01061978A
- Practice address
- 14828 Greyhound CT Ste 100
Carmel, IN 46032-5016 - Phone
- (317) 582-9200
- NPI assigned
- May 15, 2007
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 01061978A | IN | Primary |
Addresses
Primary practice location
14828 Greyhound CT Ste 100
Carmel, IN 46032-5016
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201051900 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01061978A | IN | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473811200000",
"number": "1942416250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14828 GREYHOUND CT STE 100",
"city": "CARMEL",
"state": "IN",
"postal_code": "460325016",
"telephone_number": "317-582-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROSA",
"first_name": "MELISSA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2016-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IN",
"license": "01061978A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201051900",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.