Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. John P Derosa, MD

Individual provider Body Imaging Physician · NPI 1124081302

Dr. John P Derosa, MD is a Diagnostic Radiology in Flushing, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 1992, 34 years ago. Practices with Main Street Radiology at Bayside LLC, a 56-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
34
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2006
Specialties on file
7
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5645 Main St
Flushing, NY 11355-5045
Phone: (718) 670-1594
Fax: (718) 670-1901
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 205939 (NY)
Body Imaging Physician Taxonomy 2085B0100X · Licence 205939 (NY)
Neuroradiology Physician Taxonomy 2085N0700X · Licence 205939 (NY)
Nuclear Radiology Physician Taxonomy 2085N0904X · Licence 205939 (NY)
Therapeutic Radiology Physician Taxonomy 2085R0203X · Licence 205939 (NY)
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X · Licence 205939 (NY)
Diagnostic Ultrasound Physician Taxonomy 2085U0001X · Licence 205939 (NY)

Record details

NPI number1124081302
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2006
Last updated in NPPESNovember 3, 2011
Mailing address3211 Francis Lewis Blvd, Flushing, NY 11358-1922

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 1992 (34 years in practice)
Group practice Main Street Radiology At Bayside Llc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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