Gaye Derusso, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA15294 Issued in CA

Practice address

2999 Regent St
Ste 225
Berkeley, CA 94705-2190

Phone

(510) 704-7760

Fax

(510) 704-7765

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Alta Bates Summit Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1184658783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST",
            "address_2": "STE 225",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052190",
            "telephone_number": "510-704-7760",
            "fax_number": "510-704-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST",
            "address_2": "STE 225",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052190",
            "telephone_number": "510-704-7760",
            "fax_number": "510-704-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUSSO",
        "first_name": "GAYE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA15294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Alexander DDS
• Heidi Denkers
• Greer Jewett Dent
• Grace Eryn Depriest
• Dermasmooth Electrolysis Studio LLC
• Caitlin Courtney Desmet, DDS
• Alex D Devigal, D.D.S.
• Simarjit K. Dhaliwal, MD
• Dev Singh Dhanoa, M.D.
• Conghui Di

• Surgical Physician Assistant in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.