Mark Derasmo, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

30410 Issued in MS

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 423-7342

NPI assigned

Apr 7, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1023647419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERASMO",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "30410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin D. Dellacca, IDMT
• Steven Daniel Demartini, M.D.
• Christopher Justin Dennis, D.O.
• David Michael Dennison, DDS
• Dentrust, P.C.
• Veroncia Rivas Destura, IDMT
• Laura Devlin, PHARMD
• Dfas
• Linderpal Kaur Dhillon
• Yoojeong Kim Diamant, NP

• Infectious Disease Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.