Corry Derobertis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

NA2662 Issued in CA

Practice address

4733 W Sunset Blvd
Los Angeles, CA 90027-6021

Phone

(323) 783-4011

NPI assigned

Nov 29, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1679640437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276021",
            "telephone_number": "323-783-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276021",
            "telephone_number": "323-783-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROBERTIS",
        "first_name": "CORRY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA2662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Dermenchyan, PHD, RN
• Karapet Gary Dermendjian, M.D.
• Dermking Institute
• Celia Lee Dermont, L.AC.
• Kathryn Dern, MD
• Adrineh - Derohanian, MSW
• Lorraine Derosa, APCC
• Tiffany Nicole Derosier
• Rebecca Deross, M.D.
• Derouaux Chiropractic Inc

• Certified Registered Nurse Anesthetist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.