Dr Kevin Michael Van Derveer, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Philadelphia, Pennsylvania. His current practice location is
4190 City Ave, Philadelphia, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(215) 871-6730.
Dr Kevin Michael Van Derveer is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245989854.
Physician's Profile
Full Name | Dr Kevin Michael Van Derveer |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 4190 City Ave, Philadelphia, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1245989854
- Provider Enumeration Date: 03/21/2022
- Last Update Date: 07/29/2025
Medicare PECOS Information:
- PECOS PAC ID: 4082097555
- Enrollment ID: I20220816001502
Medical Identifiers
Medical identifiers for Dr Kevin Michael Van Derveer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245989854 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 25MB12606300 (New Jersey) | Secondary |
208600000X | Surgery | OS025246 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kevin Michael Van Derveer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Kevin Michael Van Derveer, DO 4190 City Ave, Philadelphia, PA 19131-1626 Ph: () - | Dr Kevin Michael Van Derveer, DO 4190 City Ave, Philadelphia, PA 19131-1626 Ph: (215) 871-6730 |
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