DR. NICOLE M DEROSA PSY.D., BCBA-D, LBA
NPI 1427309228
Psychologist in Syracuse, NY
About Dr. Nicole M Derosa Psy.d., Bcba-d, Lba NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. NICOLE M DEROSA PSY.D., BCBA-D, LBA (NPI 1427309228) is an individual psychologist in Syracuse, New York, licensed in New York (020499) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Rome.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Nicole M Derosa Psy.d., Bcba-d, Lba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Nicole Derosa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Utica, NY 13502
- Reassigned Medicare billing, New York enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Nicole Derosa's NPI number?
The NPI number for Nicole Derosa is 1427309228. It was assigned to this individual provider in the NPPES registry on September 20, 2012.
Where is Nicole Derosa located?
Nicole Derosa practices at 100 Intrepid Ln Ste 2, Syracuse, NY 13205. The listed phone number is (315) 797-6241.
What is Nicole Derosa's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Nicole Derosa enrolled in Medicare?
Yes. Nicole Derosa is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Nicole Derosa's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Derosa reassigns Medicare benefits to Kelberman Center, Inc (Utica, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Derosa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Nicole Derosa was last updated on April 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.