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SHERYL DERDERIAN NP NPI 1801976352


NPI Information

NPI: 1801976352
Provider Name: SHERYL DERDERIAN, NP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
46 DAGGETT DRIVE
WEST SPRINGFIELD, MA
ZIP 01089
Phone: (413) 794-9110
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Sheryl Derderian, NP is a gerontology nurse practitioner in West Springfield, MA with 32 years of experience. Sheryl Derderian, NP NPI is 1801976352. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

46 DAGGETT DRIVE
WEST SPRINGFIELD, MA
ZIP 01089
Phone: (413) 794-9110
Fax: (413) 794-9116

The NPI 1801976352 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.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 10/17/2006 and was last updated on 8/1/2014.


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
1363LA2200XNurse PractitionerAdult Health156396MASSACHUSETTSNo
2207RG0300XInternal MedicineGeriatric Medicine156396MASSACHUSETTSNo
3363LG0600XNurse PractitionerGerontology156396MASSACHUSETTSYes

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
1NP1137OTHERMASSACHUSETTSCONNECTICARE
2500025819OTHERMASSACHUSETTSRAILROAD MEDICARE
3NP1137MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
4S58529MEDICARE UPINMASSACHUSETTS
50344061MEDICAIDMASSACHUSETTS
6NP1137OTHERMASSACHUSETTSBLUE CROSS

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.