Adiel Derkhidam

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

3763318 Issued in NY

Practice address

19002 Jamaica Ave
Hollis, NY 11423-2034

Phone

(718) 577-2211

NPI assigned

Mar 6, 2026

Last updated

Mar 6, 2026By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1772755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1538015235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FLORENCE ST",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231109",
            "fax_number": "516-660-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19002 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232034",
            "telephone_number": "718-577-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKHIDAM",
        "first_name": "ADIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-06",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "3763318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Defalco, PSY.D
• Ayam Tirona Deleon, PT
• Patrick Ronald Delpeche
• Dionne Denny
• Yuifun C Deocampo, AGPCNP-BC
• Esther Desir
• Ricardo Desulme
• Cora A Deveaux, R.N.
• Mariatou Diarra, LPN
• Kevin Diaz

• Primary Care Nurse Practitioner in Hollis, NY
• Providers in Hollis, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.