Robert Alexis Dery, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

43730 Issued in CO

Practice address

Dept #0861
Denver, CO 80256-0001

Phone

(866) 898-7136

Fax

(616) 975-9824

NPI assigned

Jun 2, 2006

Last updated

Nov 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Colorado West Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Grand Junction, CO
  • NPI 1780626069
  Medicare reassignment NPD

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1376581694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 E RD",
            "city": "PALISADE",
            "state": "CO",
            "postal_code": "815269558",
            "telephone_number": "970-464-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT #0861",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560001",
            "telephone_number": "866-898-7136",
            "fax_number": "616-975-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERY",
        "first_name": "ROBERT",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CO",
            "license": "43730",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A80430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00278508",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0423",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59626861",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Derouin, LP
• Christopher Derrevere, PTA
• Elizabeth Mary Derry, CPM,LM
• Cynthia Derryberry, RDH
• Megan Renee Derschang
• Anand Desai, PSYD
• Kunj K Desai, MD
• Madison Renee Desalvo, FNP-C
• Diane Deschanel, NP
• Madhuri Subhashrao Deshmukh

• Emergency Medical Services (Emergency Medicine) Physician in Denver, CO
• Providers in Denver, CO by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.