MR. DAVID J JR. DEROSIER (ACNPC-AG, CPNP-AC) – Acute Care Nurse Practitioner, NPI 1053935072
Acute Care Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
8,971 NURSE PRACTITIONER in MA
Provider Addresses for MR. DAVID J JR. DEROSIER (ACNPC-AG, CPNP-AC)
PO BOX 415348
BOSTON, MA 022415348
Phone: (800) 225-8885
Fax: (508) 334-1977
Type: Mailing
55 LAKE AVE N
PEDIATRIC CRITICAL CARE
WORCESTER, MA 016550002
Phone: (774) 442-2164
Fax: (774) 443-2062
Type: Location
323 RACE ST APT B
PHILADELPHIA, PA 191061866
Phone: (774) 535-1321
Type: Mailing
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 191044319
Phone: (215) 590-1000
Type: Location
55 Lake Ave N
Worcester, MA 016550002
Phone: (774) 441-6468
Fax: (508) 793-6315
Type: Location
300 Longwood Ave
Boston, MA 021155724
Phone: (617) 355-6000
Type: Location
123 Summer St
Worcester, MA 016081216
Phone: (508) 363-5000
Type: Location
119 Belmont St
Worcester, MA 016052903
Phone: (774) 441-6468
Fax: (508) 793-6315
Type: Location
123 SUMMER ST
WORCESTER, MA 016081216
Phone: (508) 363-5000
Type: Mailing
8200 DODGE ST
OMAHA, NE 681144113
Phone: (402) 955-5400
Type: Location
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: 2024-10-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241025002046 | I | Nurse Practitioner | MA | TBD |
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.
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 02241)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MA | |
| Pediatric Medicine, Hematology/Oncology, Internal Medicine | TN | |
| Internal Medicine | MA | |
| Nurse Practitioner | NY | |
| Internal Medicine | PA | |
| Internal Medicine | MA | |
| Critical Care (Intensivists), Internal Medicine | MA | |
| Internal Medicine | MA | |
| Internal Medicine | MA | |
| Nurse Practitioner | NY |
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