ALTA J. DEROO MD NPI 1184791725

NPI Information

  • NPI: 1184791725
  • Provider Name: ALTA J. DEROO, MD
  • Classification: Preventive Medicine - 2083A0300X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1521 GULL RD
    KALAMAZOO, MI
    ZIP 49048
  • Phone: (269) 226-5927

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NPI Details

Alta J. Deroo, MD is an addiction medicine preventive medicine in Kalamazoo, MI with 23 years of experience. The provider is a physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction. Alta J. Deroo, MD NPI is 1184791725. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduation Year:2003

The provider's business location address is:

1521 GULL RD
KALAMAZOO, MI
ZIP 49048-640
Phone: (269) 226-5927

The NPI 1184791725 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 11/29/2006 and was last updated on 10/18/2024.

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
1207V00000XObstetrics & Gynecology71806MINNESOTANo
2207V00000XObstetrics & Gynecology168454CALIFORNIANo
32083A0300XPreventive MedicineAddiction Medicine168454CALIFORNIANo
42083A0300XPreventive MedicineAddiction Medicine71806MINNESOTAYes
5207V00000XObstetrics & Gynecology4301116178MICHIGANNo
6207V00000XObstetrics & Gynecology0101237764VIRGINIANo

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: 11/21/2025

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