Kimberly Derezil, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD452662 Issued in PA

Practice address

1702 W Allen St
Allentown, PA 18104-5023

Phone

(484) 393-5883

Fax

(610) 601-4749

NPI assigned

Jan 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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.

• St. Luke'S Hospital

  • Obstetrics & Gynecology Physician
  • Bethlehem, PA
  • NPI 1508874538
  Medicare reassignment NPD
• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• Revitajuve Health and Business, PLLC

  • Family Medicine Physician
  • Allentown, PA
  • NPI 1093499915
  NPD Authorized official
• St Luke'S Hospital

  • General Acute Care Hospital
  • Easton, PA
  • NPI 1376339226
  NPD
• St Luke'S Physician Group Inc

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Brodheadsville, PA
  • NPI 1275636185
  NPD
• Planned Parenthood Keystone

  • Clinic/Center
  • Harrisburg, PA
  • NPI 1487655981
  NPD (past)

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1841561198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 W ALLEN ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045023",
            "telephone_number": "484-393-5883",
            "fax_number": "610-601-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 W ALLEN ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181045023",
            "telephone_number": "484-393-5883",
            "fax_number": "610-601-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEREZIL",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD452662",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelina Depaoli, LCSW
• Megan Depoint, D.C.
• Sabrina R Depue, PA-C
• Amy Depuy, M.D.
• Nickole Dereinzi, LPC
• Dermatology & Skin Cancer Center PC
• Leia Woelkers Derosato, D.O.
• Erica Derr
• Melissa Derr, MS
• Colin Derrico

• Family Medicine Physician in Allentown, PA
• Providers in Allentown, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.