Geo Smith Derimanov, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD068235L Issued in PA

Practice address

3400 Spruce Street
8 Penn Tower
Philadelphia, PA 19104

Phone

(215) 662-2415

NPI assigned

Jun 24, 2006

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

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1932135407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "DIVISION OF RHEUMATOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "8 PENN TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIMANOV",
        "first_name": "GEO",
        "middle_name": "SMITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD068235L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00B962240001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominic Derenge, D.O.
• Gianna Derenzi
• Elizabeth Derham, MD
• Jeffrey Joseph Derham
• Brittany Derillo
• Matthew R Dering, CRNP
• Chris T Derk, MD
• Derkat Medical Supplies Inc.
• Mary Joy Derla
• Corinne Derleth

• Rheumatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Rheumatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.