Individual provider Active NPI

Seth G Derman, MD

  • Obstetrics & Gynecology Physician
  • Lawrenceville, NJ
National Provider Identifier
1093715161
Registry record updated Jul 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA06185200 Issued in NJ
Practice address
2 Princess Rd
Ste C
Lawrenceville, NJ 08648-2302
Phone
(609) 896-0777
Fax
(609) 896-3266
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA06185200 NJ Primary

Addresses

Primary practice location

2 Princess Rd
Ste C
Lawrenceville, NJ 08648-2302

Mailing address

2 Princess Rd
Ste C
Lawrenceville, NJ 08648-2302
Phone (609) 896-0777

Other identifiers 1

IdentifierTypeStateIssuer
6898009MedicaidNJ

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
I20111222000099 NJ Practitioner - Obstetrics/Gynecology 4789679721 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Medical Associates, LLC Obstetrics & Gynecology CurrentSince Jan 28, 2018 Accepting new patients

Locations

16 Pocono Rd
Frnt
Denville, NJ 07834
Phone (973) 784-3935

2 Princess Rd
Ste C
Lawrenceville, NJ 08648
Phone (609) 896-0777

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278288000000",
    "number": "1093715161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PRINCESS RD",
            "address_2": "STE C",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482302",
            "telephone_number": "609-896-0777",
            "fax_number": "609-896-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PRINCESS RD",
            "address_2": "STE C",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482302",
            "telephone_number": "609-896-0777",
            "fax_number": "609-896-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMAN",
        "first_name": "SETH",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2010-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA06185200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6898009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.