Kyle Joseph Derowski

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Newark, DE

NPI 1194668376 · NPPES record last updated Apr 13, 2026

Key facts

NPI
1194668376
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone
(302) 733-1000
NPI assigned
Apr 13, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260513000806 DE Order and Referring Only - Emergency Medicine
Practitioner - Emergency Medicine
9931678539

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X DE Yes

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Mailing address

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000

Other practice location 1

501 W 14th St
Wilmington, DE 19801-1038
Phone (302) 733-1000

Other providers in Newark, DE

All providers in Newark, DE · Student in an Organized Health Care Education/Training Program in Delaware

Sources for this page

Verify at the official NPI Registry.