Individual provider Active NPI

David Michael Deramo, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West New York, NJ
National Provider Identifier
1063562445
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
25MA08226000 Issued in NJ
Practice address
5300 Bergenline Ave Ste 302
West New York, NJ 07093-5616
Phone
(201) 510-9999
Fax
(201) 252-0058
NPI assigned
Jan 10, 2007
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 25MA08226000 NJ Primary

Addresses

Primary practice location

5300 Bergenline Ave Ste 302
West New York, NJ 07093-5616

Mailing address

5300 Bergenline Ave Ste 302
West New York, NJ 07093-5616
Phone (201) 510-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20080104000219 NJ Practitioner - Orthopedic Surgery 1850471731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rutgers New Jersey Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5300 Bergenline Ave
Suite 302
West New York, NJ 07093-5616
Phone (201) 430-8266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Deramo Medical LLC Sports Medicine CurrentSince Jun 1, 2024 Accepting new patients
Englewood Knee & Sports Medicine PC Sports Medicine CurrentSince Jul 31, 2009 Accepting new patients
Englewood Knee & Sports Medicine, P.C. CurrentSince Jul 31, 2009 Accepting new patients

Locations

370 Grand Ave
Ste 100
Englewood, NJ 07631
Phone (201) 567-5700

5300 Bergenline Ave
Ste 302
West New York, NJ 07093
Phone (201) 430-8266

5300 Bergenline Ave
Ste 320
West New York, NJ 07093

327 60th St
West New York, NJ 07093
Phone (201) 836-5144

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1063562445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 BERGENLINE AVE STE 302",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935616",
            "telephone_number": "201-510-9999",
            "fax_number": "201-252-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 BERGENLINE AVE STE 302",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935616",
            "telephone_number": "201-510-9999",
            "fax_number": "201-252-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAMO",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA08226000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

Verify at the official NPI Registry.