Trevor Deraney, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 9104519 Issued in FL

Practice address

237 Linwood Ave
Buffalo, NY 14209-2009

Phone

(716) 248-1420

Fax

(716) 248-2026

NPI assigned

Feb 20, 2008

Last updated

Mar 15, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment NPD
• Express Care Clinic LLC

  • Primary Care Clinic/Center
  • Longwood, FL
  • NPI 1104247865
  Medicare reassignment
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD
• Orlando Carenow Urgent Care LLC

  • Urgent Care Clinic/Center
  • Winter Springs, FL
  • NPI 1205389905
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1700055068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142400488",
            "telephone_number": "203-944-1940",
            "fax_number": "203-402-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 LINWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092009",
            "telephone_number": "716-248-1420",
            "fax_number": "716-248-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERANEY",
        "first_name": "TREVOR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022142",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9104519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020626400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03217214",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne R Denz, PNP
• Mary Katherine Depalma, MS SLP
• Department of Veterans Affairs
• Jennifer Catherine Depasquale, MS-SLP-CCC
• Frances L Deplato, D.D.S.
• Jule Deren, D.O.
• Reem Dergham
• Lauren Ashley Derhodge, D.O.
• Katherine Deriso
• Michelle Marie Derkovitz, RPT

• Physician Assistant in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.