R Derosa Surgery LLC
NPI 1871209494ActiveOrganization· Surgery· Glendale, AZ
Surgery in Glendale, Arizona, registered in NPPES in January 2023. The authorized official on file is Richard Derosa, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1871209494 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 26, 2023 |
| Last updated in NPPES | Jan 26, 2023 |
| Certified by provider | Jan 26, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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