Individual provider Active NPI

Matthew Derkrikorian, RN

  • Registered Nurse
  • El Cajon, CA
National Provider Identifier
1568340248
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95111224 Issued in CA
Practice address
1257 Australia St
El Cajon, CA 92020-8806
Phone
(603) 548-4607
NPI assigned
Aug 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95111224 CA Primary

Addresses

Primary practice location

1257 Australia St
El Cajon, CA 92020-8806

Mailing address

1257 Australia St
El Cajon, CA 92020-8806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95111224CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1568340248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 AUSTRALIA ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920208806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 AUSTRALIA ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920208806",
            "telephone_number": "603-548-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKRIKORIAN",
        "first_name": "MATTHEW",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95111224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.