Sarkis Derderian, DO

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

384 Issued in SC

Practice address

1875 Harden St
Columbia, SC 29204-1014

Phone

(803) 256-0464

Fax

(803) 254-5121

NPI assigned

Jan 2, 2006

Last updated

Mar 17, 2022By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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 Osteopathy, Doctor of Medicine

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.

• Lexington Health Inc

  dba Lexington Orthopaedic and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Columbia, SC
  • NPI 1710634753
  Medicare reassignment NPD
• Carolina Pulmonary & Critical Care

  • Pulmonary Disease Physician
  • Columbia, SC
  • NPI 1225017205
  NPD
• Lexington Health Inc

  dba Carolina Pulmonary and Critical Care

  • Pulmonary Disease Physician
  • West Columbia, SC
  • NPI 1386242493
  NPD
• Lexington Health Inc

  dba Lexington Internal Medicine

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1942190988
  NPD

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1427036375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 HARDEN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 HARDEN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041014",
            "telephone_number": "803-256-0464",
            "fax_number": "803-254-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERDERIAN",
        "first_name": "SARKIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-02",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003846",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Department of Veteran Affairs (Vet Center)
• Karen E Depass-Jones, PHARM D
• Dependable Home Care LLC (N/a)
• Jack Legrand Depriest, MD
• Michelle Marie Deranieri, FNP
• Sarah Lynne Derenbecker, PT
• Phillips Ruth Deridder, MD
• Elizabeth Derks
• Tracy Deroller
• Stephanie Derr, RN

• Pulmonary Disease Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pulmonary Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.