Michelle Derouso, PTA
NPI 1134893316ActiveIndividual· Physical Therapy Assistant· Lake Forest, CA
Physical Therapy Assistant (PTA) in Lake Forest, California, licensed in CA, with an NPI issued in August 2021.
Overview
| NPI | 1134893316 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PTA |
| Sole proprietor | Yes |
| NPI issued | Aug 2, 2021 |
| Last updated in NPPES | Aug 2, 2021 |
| Certified by provider | Aug 2, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | 49501 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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