Individual provider Active NPI

Deborah S. Derderian, D.O.

  • Internal Medicine Physician
  • Mendon, MA
National Provider Identifier
1619123205
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243757 Issued in MA
Practice address
12 Uxbridge Road
Mendon, MA 01756-1311
Phone
(508) 634-6620
Fax
(508) 634-6813
NPI assigned
Aug 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 243757 MA Primary
Internal Medicine Physician 207R00000X 233213 MA

Addresses

Primary practice location

12 Uxbridge Road
Mendon, MA 01756-1311

Mailing address

9 Industrial Rd Ste 5
Milford, MA 01757-3736
Phone (508) 473-1480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207001212 MA Practitioner - Internal Medicine 0547457269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

100 Medway Rd
Milford, MA 01757-2923

12 Uxbridge Rd
Mendon, MA 01756-1094
Phone (508) 473-6320

12 Uxbridge Rd
Suite 201
Mendon, MA 01756-1095
Phone (508) 634-6620

308 Main St
Milford, MA 01757-2511
Phone (508) 478-0555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
233213MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Internal Medicine Current Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

1280 W Central St
Ste 201
Franklin, MA 02038
Phone (508) 541-2436

68A Main St
Ste 101
Medway, MA 02053
Phone (508) 533-6020

12 Uxbridge Rd
Ste 201
Mendon, MA 01756
Phone (508) 473-6320

308 Main St
Milford, MA 01757
Phone (508) 478-0555

100 Medway Rd
Ste 401
Milford, MA 01757
Phone (508) 634-7338

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1619123205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 INDUSTRIAL RD STE 5",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573736",
            "telephone_number": "508-473-1480",
            "fax_number": "508-473-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UXBRIDGE ROAD",
            "city": "MENDON",
            "state": "MA",
            "postal_code": "017561311",
            "telephone_number": "508-634-6620",
            "fax_number": "508-634-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERDERIAN",
        "first_name": "DEBORAH",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "243757",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendon, MA

Sources for this page

Verify at the official NPI Registry.