Natalie D Dereka, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501015948 Issued in MI

Practice address

1820 Shaffer St
Suite B
Kalamazoo, MI 49048-1656

Phone

(269) 384-3066

Fax

(269) 384-3065

NPI assigned

Jul 5, 2012

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nexus Physical TherapyGroup PAC ID 6305890609, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Nexus Physical Therapy

  • Physical Therapist
  • El Cajon, CA
  • NPI 1952461741
  Medicare reassignment Care Compare group NPD
• Bewell Home Physical Therapy P C

  • Physical Therapy Clinic/Center
  • San Marcos, CA
  • NPI 1831582592
  Medicare reassignment NPD
• Physiotherapy Associates Inc

  • Rehabilitation Clinic/Center
  • Kalamazoo, MI
  • NPI 1073600490
  NPD (past)

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1417212564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 SHAFFER ST",
            "address_2": "SUITE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481656",
            "telephone_number": "269-384-3066",
            "fax_number": "269-384-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 SHAFFER ST",
            "address_2": "SUITE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481656",
            "telephone_number": "269-384-3066",
            "fax_number": "269-384-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEREKA",
        "first_name": "NATALIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danyelle Denard-Johnson
• Mary Ann Dennis, AGACNP-BC
• Frances Denny, LMSW
• Jake Denny
• Iris Deodorico, M.D.
• Alta J. Deroo, MD
• Amber Deroos
• Jessica Lynn Deruiter, RN
• Desert Streams Christian Counseling
• Desert Streams Christian Counseling

• Physical Therapist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.