Derly M Heredia, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

011032 Issued in NY

Practice address

4028 82ND St
2ND Floor
Elmhurst, NY 11373-1305

Phone

(718) 478-0338

Fax

(718) 478-6050

NPI assigned

Oct 29, 2007

Last updated

Oct 29, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHFGAD/Endpoint/FHFGAD
• FHIR API: https://fhir4.healow.com/fhir/r4/GCAABA/Endpoint/GCAABA

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.

• Cuidado Medico Y Geriatrico of Queens PC

  • Internal Medicine Physician
  • Jackson Heights, NY
  • NPI 1194049502
  Medicare reassignment
• General Medical Services of Queens PC

  • Internal Medicine Physician
  • Jackson Heights, NY
  • NPI 1649334921
  Medicare reassignment
• Gabriel Gustin MD PC

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1902178486
  NPD (past)
• Sergio Sokol M.D.,F.a.C.C.,P.C.

  • Specialist
  • Cedarhurst, NY
  • NPI 1912953399
  NPD (past)

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1316126287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 82ND ST",
            "address_2": "2ND FLOOR",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-478-0338",
            "fax_number": "718-478-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 82ND ST",
            "address_2": "2ND FLOOR",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731305",
            "telephone_number": "718-478-0338",
            "fax_number": "718-478-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "DERLY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Helfman, LMHC
• Natalia Henao-Pena
• Heng Physical Therapy and Acupuncture PLLC
• Jonathan A. Henglein, P.A.
• Veronica Henry
• Kevin Heringman, MD
• Julissa Mary Hernandez, LCSW
• Patricia Hernandez, LCSW
• Monica Isabel Herrera, LCSW
• Hertzel K Sure MD LLC

• Medical Physician Assistant in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.