Active NPI
Jamal Jon Derakhshan, MD
- Diagnostic Radiology Physician
- Abington, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD449544
- Practice address
- 1200 Old York Rd
Abington, PA 19001-3720 - Phone
- (215) 964-5775
- NPI assigned
- Apr 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2018011780 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | MD449544 | PA | Primary |
Addresses
Primary practice location
1200 Old York Rd
Abington, PA 19001-3720
Mailing address
1200 Old York Rd
Abington, PA 19001-3720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200053550 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, MO, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clinical Health Care Associates of New Jersey PC
Practice addresses (Care Compare)
1006 Mantua Pike
Woodbury, NJ 08097-1221
Phone (856) 686-8282
1865 Route 70 E 130
Rad Cherry Hill
Cherry Hill, NJ 08003-2013
Phone (856) 433-2535
3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-3000
Hospital & facility affiliations
- Hospital of Univ of Pennsylvania
- Pennsylvania Hospital
- Penn Presbyterian Medical Center
- Chester County Hospital
- Doylestown Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD449544 | PA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Associates in Healthcare, Inc. | Current | Accepting new patients | |
| University of Penn-Medical Group | Diagnostic Radiology | Current | Accepting new patients |
| Clinical Health Care Associates of New Jersey PC | Current | Accepting new patients | |
| Methodist Associates in Healthcare, Inc | Current | Accepting new patients | |
| Clinical Health Care Associates of New Jersey, PC | Current | Accepting new patients | |
| Clinical Health Care Associates of New Jersey, P.C. | Diagnostic Radiology | Current | Accepting new patients |
| Montgomery County Advanced Medical Imaging, LLC | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Miracl, LLC | Current | Accepting new patients | |
| Clinical Health Care Associates of New Jersey, PC | Current | Accepting new patients | |
| Washington University | Diagnostic Radiology | Current | Accepting new patients |
| Methodist Associates in Healthcare, Inc | Diagnostic Radiology | Current | Accepting new patients |
| Radiology Group of Abington PC | Diagnostic Radiology | Current | Accepting new patients |
| University of Penn-Medical Group | Current | Accepting new patients |
Locations
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809
510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177
510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900
1865 Route 70 E
Ste 130
Cherry Hill, NJ 08003
Phone (856) 433-2535
3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113
1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880
1200 York Rd
Abington, PA 19001
Phone (215) 481-2222
3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669
2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175
2701 Blair Mill Rd
Ste 9
Willow Grove, PA 19090
Phone (215) 481-3377
Organizations & group practices 14
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.
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-
- Family Medicine Physician
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Diagnostic Radiology
-
- Diagnostic Radiology Physician
- Abington, PA
- NPI 1477541035
-
- Family Medicine Physician
- Cherry Hill, NJ
- NPI 1447260435
Diagnostic Radiology
-
- Pulmonary Disease Physician
- Cherry Hill, NJ
- NPI 1508019241
-
- Multi-Specialty Clinic/Center
- Rolla, MO
- NPI 1205304300
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1962442475
Diagnostic Radiology
-
- Neurological Surgery Physician
- Philadelphia, PA
- NPI 1790390813
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1033575352
-
- Clinic/Center
- Willow Grove, PA
- NPI 1134315369
-
- Diagnostic Radiology Physician
- Philadelphia, PA
- NPI 1558759571
-
- Surgical Oncology Physician
- Philadelphia, PA
- NPI 1871981985
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Chester, PA
- NPI 1356333579
-
- General Acute Care Hospital
- Doylestown, PA
- NPI 1225091697
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1245207521
-
- General Acute Care Hospital
- Phila, PA
- NPI 1063489342
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1851370910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718150400000",
"number": "1134410426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 OLD YORK RD",
"city": "ABINGTON",
"state": "PA",
"postal_code": "190013720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 OLD YORK RD",
"city": "ABINGTON",
"state": "PA",
"postal_code": "190013720",
"telephone_number": "215-964-5775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERAKHSHAN",
"first_name": "JAMAL",
"middle_name": "JON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-21",
"last_updated": "2024-06-12",
"certification_date": "2024-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2018011780",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "MD449544",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200053550",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "510 S Kingshighway Blvd",
"address_2": "Dept Radiology",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101016",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Abington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.