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MR. JOHN JOSEPH DEROSALIA LCSW-R
NPI 1669491163
Social Worker - Clinical in Kingston, NY

Active since July 18, 2006Opted out of Medicare · through Jul 25, 2028
276 FAIR ST, KINGSTON, NY 12401(845) 331-8384(845) 331-8384 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Mr. John Joseph Derosalia Lcsw-r NPPES

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

MR. JOHN JOSEPH DEROSALIA LCSW-R (NPI 1669491163) is an individual clinical provider in Kingston, New York, licensed in New York (R015144) and active in the NPI registry since July 2006. He has opted out of Medicare through July 25, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1669491163
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JOHN JOSEPH DEROSALIACredential: LCSW-R
Location Address276 FAIR STKingston, NY 12401-3848
Mailing Address276 Fair StKingston, NY 12401-3848 · (845) 331-8384 · Fax (845) 331-8384
Phone(845) 331-8384
Fax(845) 331-8384
Sole ProprietorYes
Enumeration DateJuly 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1669491163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · R015144
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
276 FAIR ST, Kingston, NY 12401
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Mr. John Joseph Derosalia Lcsw-r 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 July 25, 2016 through July 25, 2028.

Opt-Out Effective DateJuly 25, 2016
Opt-Out In Effect ThroughJuly 25, 2028Opt-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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $61.88 – $187.05
Typical copayment $0.00 (range $15.47 – $46.76)
Most-billed visit code NA
Established Patient
$76.88 typical visit price
range $19.92 – $151.94
Typical copayment $19.22 (range $4.98 – $37.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 John Derosalia's NPI number?

The NPI number for John Derosalia is 1669491163. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is John Derosalia located?

John Derosalia practices at 276 Fair St, Kingston, NY 12401. The listed phone number is (845) 331-8384.

What is John Derosalia's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is John Derosalia enrolled in Medicare?

No. John Derosalia has opted out of Medicare through July 25, 2028. 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 John Derosalia was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.