Marilyn M. Deridder, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

MD5036175 Issued in CA

Practice address

1211 W la Palma Ave Ste 404
Anaheim, CA 92801-2806

Phone

(714) 772-8282

Fax

(714) 772-6493

NPI assigned

Jul 30, 2018

Sex

Female

Sole proprietor

Yes

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 CA

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chest and Critical Care Consultants a Medical GroupGroup PAC ID 7911987961, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: deridder.marilyn.p1@direct.pacificpulm.nextgenshare.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.

• Chest and Critical Care Consultants a Medical Group

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1598852717

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• El-Bershawi Medical Corp

  • Critical Care Medicine (Internal Medicine) Physician
  • Riverside, CA
  • NPI 1386813103

  Multi-Specialty

  Medicare reassignment NPD
• Chest and Critical Care Consultants

  • Sleep Disorder Diagnostic Clinic/Center
  • Tustin, CA
  • NPI 1659450054
  NPD
• Pacific Professional Surgical Group Inc

  • Trauma Surgery Physician
  • Riverside, CA
  • NPI 1578341608

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  Care Compare affiliation
• St. Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1558575746
  Care Compare affiliation

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1548748858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S WEIR CANYON RD STE 328",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081962",
            "telephone_number": "714-280-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 404",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012806",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIDDER",
        "first_name": "MARILYN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2023-01-04",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "MD5036175",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "MD5036175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Riff MD Inc Steven Duckor Prof Corp El Al
• Dental Hygiene Practice of Jose Rocha, Inc.
• Theresa Marie Denton, LMFT
• Stacia Der
• Alexandra Derado
• Nikki Jo Derleth
• Derm Lounge PC
• Derm Lounge PC
• Chet Desai, D.D.S.
• Janki Desai, MS

• Acute Care Nurse Practitioner in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.