Paul Jack Der Mesropian, D.O.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

270579 Issued in NY

Practice address

113 Holland Ave
Albany Stratton VA - Division of Nephrology
Albany, NY 12208-3410

Phone

(518) 626-5000

NPI assigned

Apr 21, 2009

Sex

Male

Sole proprietor

Yes

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 Osteopathy

State licenses

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1912141979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "address_2": "ALBANY STRATTON VA - DIVISION OF NEPHROLOGY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083410",
            "telephone_number": "518-626-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "address_2": "ALBANY STRATTON VA - DIVISION OF NEPHROLOGY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083410",
            "telephone_number": "518-626-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DER MESROPIAN",
        "first_name": "PAUL",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "270579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristine Depalo, MSED, LMHC
• Department of Veterans Affairs
• Alessio Francesco Depoli, RPH
• Deowchand Depoo, M.D.
• Dion Depra
• Nicole Fame Derby, PA-C
• Timothy S. Derenzo, M.D.
• Victoria Dergachova
• Sabrina Derhammer, DPT
• Claudelle Massena Deroche

• Nephrology Physician in Albany, NY
• Providers in Albany, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.