Jenna Eliz Tan Derivera, CAA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

Practice address

1200 Pecan St SE
Washington, DC 20032-2652

Phone

(202) 823-4220

NPI assigned

May 22, 2025

Last updated

May 22, 2025By the provider in NPPES

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

Enrolled in DC

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Case Western University School of Dental Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• George Washington Univ Hospital Hospital, Washington, DC, CCN 090001

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

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.

• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment Care Compare group NPD

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

• District Hospital Partners L P

  dba The George Washington University Hospital

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1487640207
  Care Compare affiliation

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1255123345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 M ST NW FL 7",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200371434",
            "telephone_number": "202-823-4220",
            "fax_number": "202-823-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PECAN ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322652",
            "telephone_number": "202-823-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIVERA",
        "first_name": "JENNA ELIZ",
        "middle_name": "TAN",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ephraim H Deressa, PHARM D
• Lena Marie Derhally, LPC
• Hirut Deribe
• Lemise Deribe
• Netsanet Deribe
• Dermatology Associates, P.C.
• Dermoptica Inc.
• Domenic Derobertis, CAA
• Lauren Derosa
• Michele Derose

• Anesthesiologist Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Anesthesiologist Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.