Individual provider Active NPI

Derese Gela

  • Non-emergency Medical Transport (VAN)
  • Woodbridge, VA
National Provider Identifier
1235944729
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
15628 William Bayliss CT
Woodbridge, VA 22191-6072
Phone
(571) 405-8974
NPI assigned
Feb 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Network Company 342000000X
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

15628 William Bayliss CT
Woodbridge, VA 22191-6072

Mailing address

15628 William Bayliss CT
Woodbridge, VA 22191-6072
Phone (571) 405-8974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1235944729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15628 WILLIAM BAYLISS CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916072",
            "telephone_number": "571-405-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15628 WILLIAM BAYLISS CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916072",
            "telephone_number": "571-405-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELA",
        "first_name": "DERESE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.