Active NPI
Michael Derouin, DPM,FACFAS
- Primary Podiatric Medicine Podiatrist
- Key West, FL
National Provider Identifier
1356430888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- PO-000950
- Practice address
- 2780 N Roosevelt Blvd Ste 2
Key West, FL 33040-3930 - Phone
- (305) 294-5553
- Fax
- (305) 294-6670
- NPI assigned
- Oct 12, 2006
- Last updated
- May 16, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | PO-000950 | FL | Primary |
Addresses
Primary practice location
2780 N Roosevelt Blvd Ste 2
Key West, FL 33040-3930
Mailing address
2780 N Roosevelt Blvd Ste 2
Key West, FL 33040-3930
Phone (305) 294-5553
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340211800 | Medicaid | FL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO-000950 | FL | MD | Primary Podiatric Medicine Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southernmost Foot and Ankle Specialists | Primary Podiatric Medicine | Past | Accepting new patients |
| Southernmost Foot and Ankle Specialists | Primary Podiatric Medicine | Past | Accepting new patients |
| Southernmost Foot and Ankle Specialists | Primary Podiatric Medicine | Past | Accepting new patients |
| Southernmost Foot and Ankle Specialists | Primary Podiatric Medicine | Past | Accepting new patients |
| Southernmost Foot and Ankle Specialists | Primary Podiatric Medicine | Past | Accepting new patients |
| Endocrinology Specialists of South Florida, Inc | Past | Accepting new patients | |
| Miimii Thae DPM, P.a | Past | Accepting new patients |
Organizations & group practices 7
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Miami, FL
- NPI 1780078477
-
- Primary Podiatric Medicine Podiatrist
- Tavernier, FL
- NPI 1073701488
-
- Primary Podiatric Medicine Podiatrist
- Coral Gables, FL
- NPI 1104014513
-
- Primary Podiatric Medicine Podiatrist
- Marathon, FL
- NPI 1275721680
-
- Primary Podiatric Medicine Podiatrist
- Big Pine Key, FL
- NPI 1528256930
-
- Primary Podiatric Medicine Podiatrist
- Key West, FL
- NPI 1538357942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1356430888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2780 N ROOSEVELT BLVD STE 2",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330403930",
"telephone_number": "305-294-5553",
"fax_number": "305-294-6670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2780 N ROOSEVELT BLVD STE 2",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330403930",
"telephone_number": "305-294-5553",
"fax_number": "305-294-6670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROUIN",
"first_name": "MICHAEL",
"credential": "DPM,FACFAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "FL",
"license": "PO-000950",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "340211800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Key West, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.