DENNIS M DEROSA (NPI# 1245220896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245220896 |
| Entity Type | Individual |
| Full Name | DENNIS M DEROSA |
| Credential | MD |
| Practice Address |
5734 Coventry Ln Fort Wayne IN 46804-7141 |
| Mailing Address |
Po Box 633260 Cincinnati OH 45263-3260 |
| Practice Telephone | 2604367875 |
| Mailing Telephone | 3178026303 |
| Mailing Fax Number | 3178700499 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 01029440 | IN | Allopathic & Osteopathic Physicians |
| Street Address |
5734 COVENTRY LN |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-7141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457359598 | Susan A Nasri | Anesthesiology | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2005-07-12 |
| 1801338769 | Benjamin Riebesel | Registered Nurse | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2016-11-09 |
| 1841648581 | Steven Moran | Nurse Anesthetist, Certified Registered | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2016-06-02 |
| 1649628553 | Kenny Joe Wallen | Pain Medicine | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2016-06-01 |
| 1033575907 | Kimberly Glendoria Wallen | Nurse Anesthetist, Certified Registered | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2016-01-08 |
| 1619369154 | William Dalling | Nurse Anesthetist, Certified Registered | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2015-02-20 |
| 1124424262 | Danielle Aguilar | Nurse Anesthetist, Certified Registered | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2014-11-18 |
| 1023410222 | Michael J. Phythian | Registered Nurse | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2014-09-18 |
| 1023424462 | Benjamin Wisenbaker | Nurse Anesthetist, Certified Registered | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2014-07-07 |
| 1811303258 | Morgan Wisenbaker | Nurse Anesthetist, Certified Registered | 5734 Coventry Ln, Fort Wayne, IN 46804-7141 | 2014-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265858765 | James Edward Luckey | Anesthesiology | 4701 Covington Rd, Suite 18, Fort Wayne, IN 46804-5072 | 2014-03-09 |
| 1811324411 | Willliam Richard Hall | Anesthesiology | 8721 Fortuna Way, Fort Wayne, IN 46815-5724 | 2013-09-27 |
| 1760542468 | Three Rivers Anesthesia, LLC | Anesthesiology | 7956 W. Jefferson Blvd., Fort Wayne, IN 46804 | 2006-12-11 |
| 1588746838 | Andrea Waingold | Anesthesiology | 11141 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845-1714 | 2006-10-19 |
| 1487755534 | Kathryn Carboneau | Anesthesiology | 11115 Pine Bank Ct, Fort Wayne, IN 46845-1839 | 2006-09-25 |
| 1497788848 | Il-sung Kwak | Anesthesiology | 2222 Timberbrook Trl, Fort Wayne, IN 46845-9530 | 2006-07-09 |
| 1760427686 | Andrzej S. Waskiel | Anesthesiology | 10315 Dawsons Creek Blvd Ste Ab, Fort Wayne, IN 46825-1912 | 2006-06-17 |
| 1992745806 | Muhammod Ahmad | Anesthesiology | 1942 E Dupont Rd Ste A, Fort Wayne, IN 46825-1582 | 2006-06-08 |
| 1346212487 | Glenn Batiller | Anesthesiology | 11518 Tillbury Cv, Fort Wayne, IN 46845-2138 | 2006-02-03 |
| 1457336539 | Jun Wang | Anesthesiology | 10351 Dawsons Creek Blvd, Ste D, Fort Wayne, IN 46825-1904 | 2005-12-12 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.