Joy A Derusha, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.002734 Issued in IL

Practice address

1029 East 130TH Street
Chicago, IL 60643-4039

Phone

(773) 387-2519

NPI assigned

Jun 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tca Health Inc NFPGroup PAC ID 5991696643, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joy.derusha.1@15548.direct.athenahealth.com

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.

• Tca Health Inc NFP

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1184757353
  Medicare reassignment Care Compare group NPD (past)
• Tca Health Inc NFP

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1093404576
  NPD

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1396940375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 EAST 130TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434039",
            "telephone_number": "773-995-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 EAST 130TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434039",
            "telephone_number": "773-387-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUSHA",
        "first_name": "JOY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000869A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.002734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maeve Derrig, AU.D
• Maria Ida Derrig, DO
• Ariel Derringer, CNM
• Allyson Derting, MS, CGC
• Amy Derusha
• Ithaar Derweesh, MD
• Bogdan Derylo, MD
• Desai Pharmacy Inc
• Aakash J Desai
• Achyut D Desai, OD

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.