Joanna Iris Avena Depasupil, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

331657 Issued in NY

Practice address

3 Forest Ridge Rd Apt 233
Derry, NH 03038-6126

Phone

(603) 553-6753

NPI assigned

Mar 30, 2021

Sex

Female

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Flushing Hospital & Medical Center

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1548217763
  Medicare reassignment NPD
• Flushing Hospital Medical Center

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1568693174
  NPD
• Flushing Hospital & Medical Center

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1154461622
  NPD (past)

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1760060909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 FOREST RIDGE RD APT 233",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030386126",
            "telephone_number": "603-553-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FOREST RIDGE RD APT 233",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030386126",
            "telephone_number": "603-553-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPASUPIL",
        "first_name": "JOANNA IRIS",
        "middle_name": "AVENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "331657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Degenova, LCMHC
• Candace Delisio, CNM
• Gary T Della Grotta, MD
• Dawn Lee Demark-Buik, DC
• Department of Veterans Affairs
• Derry Braces PC
• Derry Cooperative School District
• Derry Counseling SVCS
• Derry Dental Associates
• Derry Imaging Center LLC

• Pediatrics Physician in Derry, NH
• Providers in Derry, NH by specialty
• Pediatrics Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.