Nicole M. Derosa, PSY.D., BCBA-D, LBA
NPI 1427309228ActiveIndividual· Psychologist· Syracuse, NY
Psychologist (PSY.D., BCBA-D, LBA) in Syracuse, New York, licensed in NY, with an NPI issued in September 2012. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1427309228 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSY.D., BCBA-D, LBA |
| Sole proprietor | No |
| NPI issued | Sep 20, 2012 |
| Last updated in NPPES | Apr 19, 2023 |
| Certified by provider | Apr 19, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 020499 | NY |
| Behavior Analyst | 103K00000X | 1107150 | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (NY) |
|---|
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