J Derek Brederson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

336768 Issued in NY

Practice address

60 Main St
Port Byron, NY 13140-0359

Phone

(315) 776-9700

Fax

(315) 776-9701

NPI assigned

Aug 2, 2011

Last updated

Feb 14, 2014By 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 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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment NPD
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608
  Medicare reassignment NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• Rochester General Hospital

  dba Genesee Health Services

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1760557656
  NPD

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1790063162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAIDEN LN",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271208",
            "telephone_number": "315-531-9102",
            "fax_number": "315-531-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAIN ST",
            "city": "PORT BYRON",
            "state": "NY",
            "postal_code": "131400359",
            "telephone_number": "315-776-9700",
            "fax_number": "315-776-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDERSON",
        "first_name": "J",
        "middle_name": "DEREK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chrystal Behm, L.P.N.
• Julia Boyd, LPN
• Brave North Therapy, LCSW, PLLC
• Tammy Lynn Brown, LPN
• Cindy B. Darcy, O.T.R/L
• Finger Lakes Community Health
• Kimberly H Fortin, LCSW-R
• Herbst Pharmacy Inc

• Family Nurse Practitioner in Port Byron, NY
• Providers in Port Byron, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.