Kevin G Derus, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

26546-020 Issued in WI

Practice address

946 N Van Buren St
Milwaukee, WI 53202-3216

Phone

(414) 276-4242

NPI assigned

Apr 10, 2006

Last updated

Sep 26, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1811950025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 N VAN BUREN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023216",
            "telephone_number": "414-276-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 N VAN BUREN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023216",
            "telephone_number": "414-276-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUS",
        "first_name": "KEVIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "26546-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30648800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah P Derose
• Peter Forbes Derpinghaus, MSW, LCSW
• Mary J Derse-Hayes, P.A.
• Arthur R. Derse, MD
• Jeffrey A. Derus, MD
• Emily Deruyter, PT, DPT
• Brittany Rose Derynda, MPH, DO
• Brinda Desai, M.D.
• Neal Arvind Desai, DDS
• Rupen Rajesh Desai, M.D.

• Emergency Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.