Deramo Medical LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

DERAMO MEDICAL LLC

Practice address

5300 Bergenline Ave
West New York, NJ 07093-5616

Phone

(201) 510-9999

NPI assigned

May 31, 2024

Organization subpart

No

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

Authorized official

Name

Michelle Gebhardt

Title

Practice Administrator

Phone

(201) 510-9999

Specialties & licenses 1

Addresses

Other names 1

• Deramo Orthopaedics Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Michael Deramo, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West New York, NJ
  • NPI 1063562445
  Medicare reassignment NPD
• Thomas Sernas, PA-C

  • Surgical Physician Assistant
  • Florham Park, NJ
  • NPI 1548339013
  NPD

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1134969652",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935616",
            "telephone_number": "201-510-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERAMO MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "GEBHARDT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "201-510-9999"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deramo Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deramo Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ketty Acasia Davila, RN- PMHNP STUDENT
• Maria Jose De la Hoz, D.D.S
• Jorge L Delvalle, D.M.D
• Dennis L. Aponte, M.D., LLC
• Dentistry for All Wny LLC
• David Michael Deramo, M.D.
• Devaria LLC
• Devipriyathirugnanasambandam LLC
• Agustin Diaz, MD
• Sarah Elizabeth Dibble, DDS

• Sports Medicine (Orthopaedic Surgery) Physician in West New York, NJ
• Providers in West New York, NJ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.