Shannon Derose, RPA-C
NPI 1407004898 · Surgical Physician Assistant · Rochester, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shannon Derose, RPA-C is a Surgical Physician Assistant provider in Rochester, NY (NPI 1407004898).
Provider details
- NPI number
- 1407004898
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- RPA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 012694 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
Mailing address
Additional practice locations (1)
- 2115 Chili AveRochester, NY 14624-3425Phone: (585) 723-7600Fax: (585) 247-0075
Registry dates
- Enumerated
- 2008-08-28
- Last updated
- 2022-09-14
- Certified
- 2022-09-14
Frequently asked questions
- What is Shannon Derose's NPI number?
- Shannon Derose's National Provider Identifier (NPI) is 1407004898, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shannon Derose's specialty?
- Shannon Derose is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Shannon Derose located?
- Shannon Derose's practice location on file with NPPES is 125 Red Creek Dr Ste 205, Rochester, NY 14623-4262.
- What is Shannon Derose's phone number?
- The practice phone number listed in the NPPES registry for Shannon Derose is (585) 723-7600.
- Does Shannon Derose accept Medicare?
- Shannon Derose is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shannon Derose's NPI active?
- Yes — Shannon Derose's NPI (1407004898) is active in the NPPES registry as of the last update on 2022-09-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.