Rebeca Clerville Deratus, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

335173 Issued in NY

Practice address

1 Penn Plaza 7TH FL Ste 725
Evercare United Healthcare
New York, NY 10119

Phone

(212) 216-6568

Fax

(212) 216-6606

NPI assigned

Oct 1, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Park Avenue Medical Associates, P.C.

  • Geriatric Medicine (Family Medicine) Physician
  • White Plains, NY
  • NPI 1730138645
  NPD

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1912194358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENN PLAZA 7TH FL STE",
            "address_2": "EVERCARE UNITED HEALTHCARE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10119",
            "telephone_number": "212-216-6568",
            "fax_number": "212-216-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLAZA 7TH FL STE 725",
            "address_2": "EVERCARE UNITED HEALTHCARE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10119",
            "telephone_number": "212-216-6568",
            "fax_number": "212-216-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERVILLE DERATUS",
        "first_name": "REBECA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavon Clenkian, R.N.
• Cleos Glam Care
• Shari-Ann Clerge, PHARMD
• Soshana Clerizier, M.D.
• Kevin Clerkin, MD
• Bakeishia Cleveland
• Lincoln Mather Cleveland, MD
• Jill Clibborn Booth
• Catherine Cliche
• Clifford Wayne Bassett MD, PC (Allergy & Asthma Care of Ny)

• Family Nurse Practitioner in New York, NY
• Providers in New York, 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 Sep 14, 2009; 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.