IndividualActive
Elizabeth Derose, MD
NPI 1265650667 · Child & Adolescent Psychiatry Physician · Grand Rapids, MI
Provider details
- NPI number
- 1265650667
- Entity type
- Individual
- Primary specialty
- Child & Adolescent Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 4301106410 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
300 68th St Se
Grand Rapids, MI 49548-6927
Phone: (616) 281-6372
Fax: (616) 281-6459
Street-level locationGet directions
Mailing address
360 Grand River Dr Ne
Ada, MI 49301-9597
Additional practice locations (1)
- 790 Fuller Ave NeGrand Rapids, MI 49503-1918Phone: (616) 336-3909Fax: (616) 336-8830
Registry dates
- Enumerated
- 2007-04-23
- Last updated
- 2023-09-28
- Certified
- 2023-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.