Jose Franklin Derr, D.O.
Individual provider Active NPI Family Medicine Physician · Berwick, PA
NPI 1942298070 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1942298070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- OS004657L (PA)
- Practice address
- 101 W 9TH St
Berwick, PA 18603-3024 - Phone
- (570) 759-2600
- Fax
- (570) 759-3229
- NPI assigned
- Oct 12, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100423000124 | PA | Practitioner - Family Practice | 6608903612 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS004657L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berwick Clinic Company LLC | Family Medicine | Current |
Accepting new patients |
| Advanced Chiropractic PC | Current |
Accepting new patients | |
| Wyoming Valley Spine and Nerve Institute, Inc | Past |
Accepting new patients | |
| Bloomsburg Physicians Services | Family Medicine | Past | Accepting new patients |
Locations
2409 S Park Rd
Bethel Park, PA 15102
Phone (412) 595-7332
Interoperability endpoints
- https://api.platform.athenahealth.com/1704/brand/1/csg/81/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS004657L | PA | Yes |
Addresses
Primary practice location
101 W 9TH St
Berwick, PA 18603-3024
Mailing address
101 W 9TH St
Berwick, PA 18603-3024
Phone (570) 759-2600
Other providers in Berwick, PA
- Roger F Crake
- Megan Colleen Crawford
- David Curfman
- John E Definnis
- Dental Health Clinic
- Sherri Lyn Derr
- Diakon Lutheran Social Ministries
- Ashley Nicole Dolman
- Robert Dougherty
- Lisa K Draper
All providers in Berwick, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.