Justin Michael Dersch, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2022026550 Issued in MO

Practice address

1000 W Nifong Blvd
BLDG 2, Ste 220
Columbia, MO 65203-5615

Phone

(573) 882-5673

Fax

(573) 884-4625

NPI assigned

Apr 22, 2016

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

Enrolled in MO

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

Specialty

General Surgery

Education

University of Florida College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vohra Wound Physicians of FL LLCGroup PAC ID 6406039882, 73 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as group

Quality

78.58

Promoting interoperability

99

Improvement activities

40

Cost

77.82

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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.

• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1407146707

  MO

  Medicare reassignment Care Compare group NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  Medicare reassignment NPD
• Ozarks Medical Center

  • Psychiatric Hospital Unit
  • West Plains, MO
  • NPI 1235929027
  NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Conyers, GA
  • NPI 1598061293
  NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1205130911
  NPD (past)

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1780038083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD",
            "address_2": "BLDG 2, STE 220",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "573-882-5673",
            "fax_number": "573-884-4625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "657752029",
            "country_code": "US",
            "telephone_number": "417-256-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERSCH",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2022026550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "1000 W Nifong Blvd",
            "address_2": "Bldg 2, Ste 220",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652035615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Regina Heyl Depietro, M.D.
• Dermatology Center of Columbia, LLC
• Christopher J Derose, O.D.
• Bret Sheridan Derrick, PT, DPT, OCS
• Karen Derrick, RD
• Leslie Joan Desha, FNP
• Thiago Queiroz Desouza, M.D.
• Darla K Despain, FNP
• Alexis Raeann Detienne
• Courtney Aileen Detringo, MAT, LAT, ATC

• Surgery Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.