MICHAEL A DEROSA (MD) – Ophthalmology Physician, NPI 1275524662

MICHAEL A DEROSA (MD) is a healthcare provider. based in Snellville, Georgia. specializing in Ophthalmology Physician. They hold the professional credentials MD. They hold a License No. 033954 (GA). The NPI Number for MICHAEL A DEROSA (MD) is 1275524662

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL A DEROSA (MD)
NPI
1275524662
Phone
(770) 979-2020
Address
2347 LENORA CHURCH RD
Enumeration Date
3 November 2005
Last Update Date
23 June 2016

Doctor Profile

Medical School Name
JS WEILL MEDICAL COLLEGE, CORNELL UNIVERSITY
Secondary Phone
7709792020
Graduation Year
1986 (40 years ago)
PAC ID
2567645013
Group Practice PAC ID
4183693641
Professional Enrollment ID
I20110322000418
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MICHAEL A DEROSA (MD)

  • 2347, Lenora Church Road, Snellville, Gwinnett County, Georgia, 30078, United States

    SNELLVILLE, GA 300783232

    Phone: (770) 979-2020

    Fax: (770) 978-3321

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110322000418IOphthalmologyGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30078)

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Provider's Procedures

MICHAEL A DEROSA (MD) performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYGA92083Measurement of field of vision during daylight conditions6259
OPHTHALMOLOGYGA92134Diagnostic imaging of retina4138

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183693641View full group profile
NameSpecialtyState
O P H T H A L M O L O G YGA
O P H T H A L M O L O G YGA
O P H T H A L M O L O G YGA
O P H T H A L M O L O G YGA
O P H T H A L M O L O G YKY
O P H T H A L M O L O G YGA
O P H T H A L M O L O G YGA
O P T O M E T R YGA

Reviews

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Frequently asked questions

How do payers reference MICHAEL A DEROSA (MD)?
For MICHAEL A DEROSA (MD), use NPI 1275524662 as the unique 10-digit identifier.
Is MICHAEL A DEROSA (MD) still an active registrant?
MICHAEL A DEROSA (MD) carries an active NPI according to the public dataset.
How would a patient describe MICHAEL A DEROSA (MD)'s focus?
For MICHAEL A DEROSA (MD), the primary taxonomy reads as Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Is MICHAEL A DEROSA (MD) associated with Snellville?
Public fields place MICHAEL A DEROSA (MD) around Snellville, Georgia. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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