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JAIMIE DEROSA M.D.
NPI 1023057031
Otolaryngology - Facial Plastic Surgery in Boston, MA

Active since June 05, 2006Opted out of Medicare · through Jan 1, 2027
91 NEWBURY ST, SUITE 300, BOSTON, MA 02116(617) 262-8000(617) 262-8002 Get Directions Write a Review

NPPES record last updated: May 24, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jaimie Derosa M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAIMIE DEROSA M.D. (NPI 1023057031) is an individual facial plastic surgery provider in Boston, Massachusetts, licensed in Massachusetts (237016) and active in the NPI registry since June 2006. She has opted out of Medicare through January 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1023057031
Entity TypeIndividualFemale
Primary Taxonomy207YS0123X
Provider Legal NameJAIMIE DEROSACredential: M.D.
Location Address91 NEWBURY ST, SUITE 300Boston, MA 02116-3084
Mailing Address91 Newbury St, Suite 300Boston, MA 02116-3084 · (617) 262-8000 · Fax (617) 262-8002
Phone(617) 262-8000
Fax(617) 262-8002
Sole ProprietorNo
Enumeration DateJune 5, 2006
Last NPPES UpdateMay 24, 2013
✔ NPI 1023057031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YS0123X
License✔ Licensed in MA · 237016
Definition

An otolaryngologist who specializes in facial plastic surgery.

Also ListedOtolaryngologyTaxonomy 207Y00000X · License 237016 (MA)
91 NEWBURY ST, Boston, MA 02116
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jaimie Derosa M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2017 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2017
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEROSA FACIAL PLASTIC SURGERY PC
Otolaryngology (Plastic Surgery within the Head & Neck)
91 NEWBURY ST, SUITE 300
BOSTON, MA 02116
Suffolk County (617) 262-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaimie Derosa's NPI number?

The NPI number for Jaimie Derosa is 1023057031. It was assigned to this individual provider in the NPPES registry on June 5, 2006.

Where is Jaimie Derosa located?

Jaimie Derosa practices at 91 Newbury St Suite 300, Boston, MA 02116. The listed phone number is (617) 262-8000.

What is Jaimie Derosa's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

Is Jaimie Derosa enrolled in Medicare?

No. Jaimie Derosa has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jaimie Derosa was last updated on May 24, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.