JAIMIE DEROSA M.D. NPI 1023057031

NPI Information

NPI: 1023057031
Provider Name: JAIMIE DEROSA, M.D.
Classification: Otolaryngology - 207YS0123X
Entity Type: Individual

Specialization: Facial Plastic Surgery

PECOS Registration: Yes

Address:
91 NEWBURY ST
SUITE 300
BOSTON, MA
ZIP 02116
Phone: (617) 262-8000
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Jaimie Derosa, M.D. is a facial plastic surgery otolaryngology in Boston, MA. The provider is an otolaryngologist who specializes in facial plastic surgery. Jaimie Derosa, M.D. NPI is 1023057031. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

91 NEWBURY ST
SUITE 300
BOSTON, MA
ZIP 02116-084
Phone: (617) 262-8000
Fax: (617) 262-8002

The NPI 1023057031 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/5/2006 and was last updated on 5/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Y00000X	Otolaryngology		237016	MASSACHUSETTS	No
2	207YS0123X	Otolaryngology	Facial Plastic Surgery	237016	MASSACHUSETTS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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