Active NPI
Dermis Edith De Jesus, MA CCC-SLP
- Speech-Language Pathologist
- Philadelphia, PA
National Provider Identifier
1356282651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL004982L
- Practice address
- 139 E Washington LN
Philadelphia, PA 19144-2010 - Phone
- (267) 275-3626
- NPI assigned
- Apr 2, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL004982L | PA | Primary |
Addresses
Primary practice location
139 E Washington LN
Philadelphia, PA 19144-2010
Mailing address
139 E Washington LN
Philadelphia, PA 19144-2010
Phone (267) 275-3626
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL004982L | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775088000000",
"number": "1356282651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 E WASHINGTON LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191442010",
"telephone_number": "267-275-3626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 E WASHINGTON LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191442010",
"telephone_number": "267-275-3626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS",
"first_name": "DERMIS",
"middle_name": "EDITH",
"credential": "MA CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-02",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL004982L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.