Andrew John Deridder, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71015716A Issued in IN

Practice address

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Phone

(317) 528-5000

NPI assigned

Sep 25, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health White Memorial Hospital Hospital, Monticello, IN, CCN 151312
• Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843
  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Arnett Inc

  dba IU Health Arnett Hospital

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1326296211
  Care Compare affiliation
• Indiana University Health White Memorial Hospital Inc

  • Critical Access Hospital
  • Monticello, IN
  • NPI 1710983945
  Care Compare affiliation

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1144009713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378601",
            "telephone_number": "317-528-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "IN",
            "postal_code": "479608201",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "574-583-9502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERIDDER",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IN",
            "license": "28267039A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71015716A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aderidder@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "810 S 6th St",
            "city": "Monticello",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479608201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.