Derek Paul Deyoung, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

635025 Issued in NY

Practice address

400 Forest Ave
Buffalo, NY 14213-1207

Phone

(716) 816-2444

Fax

(716) 816-2161

NPI assigned

Jan 3, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706313600000",
    "number": "1609646553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SYLVAN PKWY",
            "city": "AKRON",
            "state": "NY",
            "postal_code": "140011514",
            "telephone_number": "716-812-5356",
            "fax_number": "716-816-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FOREST AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131207",
            "telephone_number": "716-816-2444",
            "fax_number": "716-816-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "DEREK",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "635025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Dewey
• Seth G Dewey, MD
• Danielle Dexheimer
• Dexter Prescription Center Inc
• Elisabeth U Dexter, MD
• Timothy Dezastro, MD
• Rajveer Dhaliwall
• Arpan Dharia, MD
• Ananda Coomaraswamy Dharshan, MD
• Aliza Dharssi, M.D.

• Administrator Registered Nurse in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Administrator Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2024; 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.