Ina Dervishi, MD

Primary specialty

Neurocritical Care PhysicianTaxonomy code 2084A2900X

License

71267 Issued in AZ

Practice address

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Phone

(480) 331-6721

Fax

(480) 296-7738

NPI assigned

Jun 21, 2018

Last updated

May 10, 2024By 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 7

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Neuropsychiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurocritical Care and Stroke of Arizona PLLCGroup PAC ID 0143493882, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014
• Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038
• Honorhealth Deer Valley Medical Center Hospital, Phoenix, AZ, CCN 030092
• Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087
• Honorhealth Scottsdale Thompson Peak Med Ctr Hospital, Scottsdale, AZ, CCN 030123

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neurocritical Care and Stroke of Arizona PLLC

  • Vascular Neurology Physician
  • Phoenix, AZ
  • NPI 1649561580

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD

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

• Honorhealth

  dba HonorHealth Scottsdale Shea Medical Center

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1386608859
  Care Compare affiliation
• Honorhealth

  dba HonorHealth Scottsdale Thompson Peak Medical Center

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1417152745
  Care Compare affiliation
• Honorhealth

  dba HonorHealth Deer Valley Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1528169125
  Care Compare affiliation
• Honorhealth

  dba HonorHealth John C. Lincoln Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation
• Honorhealth

  dba HonorHealth Scottsdale Osborn Medical Center

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1811951429
  Care Compare affiliation

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1225522212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E DUNLAP AVE STE I-279",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202807",
            "telephone_number": "480-331-6721",
            "fax_number": "480-296-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "480-331-6721",
            "fax_number": "480-296-7738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave # Mc2030",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "773-702-6222",
            "fax_number": "773-834-7250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERVISHI",
        "first_name": "INA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125071970",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "71267",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "AZ",
            "license": "71267",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "AZ",
            "license": "71267",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.071970",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "71267",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "71267",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Dersam, MD
• Anne Merrylees Dersch, MD
• Michael H Dershowitz, DPM
• Shockie M Dersno, LPC
• Jenna Derubeis, OD
• Juniper Dery-Chaffin, PA-C
• Anish Kumar Desai, MD
• Dev M. Desai, M.D.
• Nima Manish Desai, M.D.
• Premal Jitendra Desai, M.D.

• Neurocritical Care Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Neurocritical Care Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.