Holly Derubeis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW024086 Issued in PA

Practice address

7520 State Rd
Philadelphia, PA 19136-3411

Phone

(484) 832-0521

NPI assigned

Feb 22, 2024

Sex

Female

Sole proprietor

Yes

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

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Philadelphia Fight

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1760507859
  Medicare reassignment NPD
• Philadelphia Fight

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1487082608
  NPD

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1215793740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 VIRGINIA AVE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 STATE RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191363411",
            "telephone_number": "484-832-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUBEIS",
        "first_name": "HOLLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Lynn Derosier
• Jovenah Jovenah Derozier, CCHW
• William Derrick Jr., FNP-C
• Krystina Derrickson, CPM
• Pier Derrickson, L.AC
• Gregory Louis Derusso, M.D.
• Patricia Ann Derusso, C.R.N.P.
• Peggy Anne Derusso, CRNP
• Migena Brati Dervishi
• Ajit Desai, MD

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.