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

Individual provider Physician Assistant · NPI 1588118707

Gilead Derose, PA-C is a Physician Assistant in Bronx, New York. Qualified in 2016, 10 years ago. Practices with Modern Physician Services PC, a 53-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
10
Licensed in
NY
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3424 Kossuth Ave
Bronx, NY 10467-2410
Phone: (718) 519-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 019974 (NY)

Record details

NPI number1588118707
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 4, 2016
Last updated in NPPESDecember 16, 2020
Certification dateDecember 16, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Modern Physician Services Pc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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