EXCLUDEDPROVIDER
Individual Revocation

Michael Anthony Derose

Pueblo, CO 81007

Public HHS-OIG LEIE exclusion record

Michael Anthony Derose of Pueblo, CO is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1033185871 with a primary specialty of Dentist, General Practice. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Michael Anthony Derose is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of August 19, 2010.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Pueblo, CO 81007
Exclusion date
August 19, 2010
Exclusion type
Revocation (1128b4)
NPI
1033185871

Record summary

Michael Anthony Derose appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Pueblo, Colorado. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is August 19, 2010, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateAugust 19, 2010
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI1033185871
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Pueblo, CO 81007. The listed provider category is Dental Practice. The listed specialty is Dentist.

NPI Registry context

The LEIE record lists NPI 1033185871. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Dentist, General Practice (1223G0001X). Registered practice location: Pueblo, CO. NPI enumeration date: Feb 23, 2006. NPPES status: Active.

NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.

Other excluded providers in Pueblo, CO

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Pueblo, CO address.

Antanette Marie Garcia Individual Revocation
Pueblo, CO · License revocation, suspension, or surrender · Excluded Jan 2026
Stephanie Louise Berresford Individual Revocation
Pueblo, CO · License revocation, suspension, or surrender · Excluded Nov 2025
Robert Gabriel Nolan Individual Revocation
Pueblo, CO · License revocation, suspension, or surrender · Excluded Oct 2025
Lindsay Leigh Harford Individual Revocation
Pueblo, CO · License revocation, suspension, or surrender · Excluded Oct 2025
Brent Ray Ellis Individual Revocation
Pueblo, CO · License revocation, suspension, or surrender · Excluded Oct 2025
Mary Ann Patton Individual Patient Abuse
Pueblo, CO · Conviction relating to patient abuse or neglect · Excluded Sep 2025
Renee Danielle Fasano Individual Program Crime
Pueblo, CO · Conviction of program-related crimes · Excluded Jul 2025
Michelle Austamarie Brunner Individual Revocation
Pueblo, CO · License revocation, suspension, or surrender · Excluded Feb 2025

See all 90 excluded providers in Pueblo →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

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