Doug Derusse

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PT-2023-0013 Issued in NM

Practice address

312 Ruins Rd Lot 49
Aztec, NM 87410-1624

Phone

(620) 210-0000

NPI assigned

Oct 17, 2026

Last updated

Oct 17, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1792195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792195200000",
    "number": "1548166341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 RUINS RD LOT 49",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 RUINS RD LOT 49",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101624",
            "telephone_number": "620-210-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUSSE",
        "first_name": "DOUG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-17",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "PT-2023-0013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Corbin, RN
• Journii Cordova
• Joshua Cowden
• Dallin Bassett OD LLC
• Laberta Dempsey, CNP
• Renee Donaldson
• Amethyst R Douglas
• Megan Lora Dunovan, PA
• Julianna Marie Duran, RN
• James Golden Durfey, DDS

• Physical Therapy Assistant in Aztec, NM
• Providers in Aztec, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.