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DR. MARY JENNIFER DEREBERY NPI 1457440992


NPI Information

NPI: 1457440992
Provider Name: DR. MARY JENNIFER DEREBERY
Classification: Otolaryngology - 207YX0602X
Entity Type: Individual

Specialization: Otolaryngic Allergy

Organization: HOUSE EAR CLINIC INC

PECOS Registration: Yes

Address:
2100 W 3RD ST
SUITE 111
LOS ANGELES, CA
ZIP 90057
Phone: (213) 483-9930
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DR. Mary Jennifer Derebery is an otolaryngic allergy otolaryngology in Los Angeles, CA with 45 years of experience. The provider is an otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases. DR. Mary Jennifer Derebery NPI is 1457440992. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEMPHIS HOSPITAL MEDICAL COLLEGE
Graduation Year:1979

The provider's business location address is:

2100 W 3RD ST
SUITE 111
LOS ANGELES, CA
ZIP 90057-944
Phone: (213) 483-9930
Fax: (213) 483-0905

The NPI 1457440992 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Preparation and provision of single or multiple antigens for allergen immunotherapy (HCPCS:95165)
  • Injection of allergenic extracts into skin for immediate reaction analysis (HCPCS:95024)
  • Removal of impact ear wax, one ear (HCPCS:69210)
  • Air and bone conduction assessment of hearing loss and speech recognition (HCPCS:92557)
  • Assessment of eardrum and muscle function (HCPCS:92550)

The enumeration date for this NPI number is 10/12/2006 and was last updated on 8/15/2013.


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
1207YX0602XOtolaryngologyOtolaryngic AllergyC42073CALIFORNIAYes

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
1WC42073BMEDICARE PINCALIFORNIA
2C42073MEDICARE PINCALIFORNIA
3A89133MEDICARE UPIN

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: 11/14/2023

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.