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JOSE JAVIER DERDOY MD NPI 1396838876


NPI Information

NPI: 1396838876
Provider Name: JOSE JAVIER DERDOY, MD
Classification: Pediatrics - 2080P0206X
Entity Type: Individual

Specialization: Pediatric Gastroenterology

PECOS Registration: Yes

Address:
615 S NEW BALLAS RD
CHILDREN'S HOSPITAL, GROUND FLOOR, SUITE YG220
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 251-5550
Get Directions

Jose Javier Derdoy, MD is a pediatric gastroenterology pediatrics in Saint Louis, MO. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. Jose Javier Derdoy, MD NPI is 1396838876. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

615 S NEW BALLAS RD
CHILDREN'S HOSPITAL, GROUND FLOOR, SUITE YG220
SAINT LOUIS, MO
ZIP 63141-221
Phone: (314) 251-5550
Fax: (314) 251-5552

The NPI 1396838876 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 1/8/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist430654872MISSOURINo
22080P0206XPediatricsPediatric Gastroenterology2007002166MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1I15114MEDICARE UPINCALIFORNIA
21396838876MEDICAIDMISSOURI
300A730200MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.