Kristin M Derderian, DO

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

5101013350 Issued in MI

Practice address

28080 Grand River Ave Ste 306
Farmington Hills, MI 48336-5966

Phone

(947) 521-8314

Fax

(248) 478-8864

NPI assigned

Oct 18, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Infectious DiseaseAlso: Internal Medicine

Education

Michigan State University College of Osteopathic Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kderderianmarten1231132@epic00.shdirect.org
• Direct secure messaging: kderderianmarten96485@direct.beaumont.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• Botsford General Hospital

  • General Acute Care Hospital
  • Farmington Hills, MI
  • NPI 1336183367
  NPD (past)
• Neighborhood Medical Centers, Inc

  • Family Medicine Physician
  • Wake Forest, NC
  • NPI 1760417075
  NPD (past)

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

• Botsford General Hospital

  • Podiatrist
  • Farmington Hills, MI
  • NPI 1093828303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Dearborn Heights, MI
  • NPI 1114935566

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • General Acute Care Hospital
  • Farmington Hills, MI
  • NPI 1336183367
  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1538103395

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Farmington Hills, MI
  • NPI 1871521153

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1871907303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1912335373

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Pulmonary Disease Physician
  • Farmington Hills, MI
  • NPI 1912915349

  Hospital

  Care Compare affiliation
• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1376624130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1862",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28080 GRAND RIVER AVE STE 306",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365966",
            "telephone_number": "947-521-8314",
            "fax_number": "248-478-8864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14510 Northline Rd",
            "address_purpose": "LOCATION",
            "city": "Southgate",
            "state": "MI",
            "postal_code": "481952402",
            "country_code": "US",
            "telephone_number": "734-282-2800",
            "fax_number": "734-282-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERDERIAN",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "5101013350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kderderianmarten96485@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "28080 Grand River Ave Ste 306",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Infectious Disease Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Infectious Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.
• 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.