Elizabeth Derham, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD451087 Issued in PA

Practice address

840 Walnut St Ste 1230
Philadelphia, PA 19107-5109

Phone

(215) 928-3041

Fax

(215) 928-3225

NPI assigned

Jun 23, 2008

Last updated

Nov 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Elizabeth Blidner Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Ophthalmology

Education

Jefferson Medical College of Thomas Jefferson University, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wills Eye Ophthalmology Clinic, IncGroup PAC ID 9133025166, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wills Eye Hospital Hospital, Philadelphia, PA, CCN 390331

Merit-based Incentive Payment System (MIPS)

Final score

87.34 of 100Reported as group

Quality

80.85

Promoting interoperability

100

Improvement activities

40

Cost

76.95

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.derham.p1@direct.willseye.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Wills Eye Ophthalmology Clinic, Inc

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1184624009
  Medicare reassignment Care Compare group NPD
• Corneal Associates of New Jersey

  • Ophthalmology Physician
  • West Orange, NJ
  • NPI 1437103991
  NPD (past)
• Omni Eye Specialists P a

  dba Omni Eye Services

  • Ophthalmology Physician
  • Iselin, NJ
  • NPI 1376593863
  NPD (past)

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

• City of Phila Trustee Acting by the BRD of Dir of City Trusts

  dba Wills Eye Hospital

  • Special Hospital
  • Philadelphia, PA
  • NPI 1881899284
  Care Compare affiliation

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1144481060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1230",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1230",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3041",
            "fax_number": "215-928-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERHAM",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA09094200",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD451087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "364763",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BLIDNER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda Gerard Derbyshire, IBCLC
• Julius J Deren, MD
• Christina Elyse Derenge, PSYD
• Dominic Derenge, D.O.
• Gianna Derenzi
• Jeffrey Joseph Derham
• Brittany Derillo
• Geo Smith Derimanov, MD
• Matthew R Dering, CRNP
• Chris T Derk, MD

• Ophthalmology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.