Stacy Derzie

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

001338001 Issued in NY

Practice address

2145 West St
Brooklyn, NY 11223-4712

Phone

(347) 217-7822

NPI assigned

Sep 16, 2014

Last updated

Sep 16, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1063814549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 WEST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234712",
            "telephone_number": "347-217-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 WEST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234712",
            "telephone_number": "347-217-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERZIE",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "001338001",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "001338001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
            "identifier": "001338001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Derujinsky Selnick
• Muriel Dervich
• Samira Dervisevic Rezika, MSED, BCBA, NYS LBA
• Richard Faator Dery, MD
• Alan Derzie, MD
• Mallory Des Champs
• Victoria Des Vignes
• Ami M Desai, M.D.
• Anubhooti Emmanuel Desai
• Bhadresh D Desai

• Case Manager/Care Coordinator in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.