Gregory Paul Derderian, DO is a medicare enrolled "Surgery - Vascular Surgery" physician in Birmingham, Michigan. He went to Kansas City College Of Medicine And Surgery and graduated in 1976 and has 48 years of diverse experience with area of expertise as Vascular Surgery. His current practice location is
538 N Old Woodward Ave, Birmingham, Michigan. You can reach out to his office (for appointments etc.) via phone at
(248) 594-3091.
Gregory Paul Derderian is licensed to practice in Michigan (license number 5101007182) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1457355737.
Physician's Profile
| Full Name | Gregory Paul Derderian |
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| Gender | Male |
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| Speciality | Vascular Surgery |
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| Experience | 48 Years |
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| Location | 538 N Old Woodward Ave, Birmingham, Michigan |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Gregory Paul Derderian attended and graduated from Kansas City College Of Medicine And Surgery in 1976
NPI Data:
- NPI Number: 1457355737
- Provider Enumeration Date: 06/02/2005
- Last Update Date: 09/18/2012
Medicare PECOS Information:
- PECOS PAC ID: 8426141979
- Enrollment ID: I20070829000825
Medical Identifiers
Medical identifiers for Gregory Paul Derderian such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457355737 | NPI | - | NPPES |
| 4406461 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2086S0129X | Surgery - Vascular Surgery | 5101007182 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gregory Paul Derderian allows following entities to bill medicare on his behalf.
| Entity Name | Michigan Vascular Institute Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093915910
PECOS PAC ID: 6507959061
Enrollment ID: O20070829000839 |
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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. Gregory Paul Derderian 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 |
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Gregory Paul Derderian, DO
538 N Old Woodward Ave,
Birmingham, MI 48009-5375
Ph: (248) 594-3091 | Gregory Paul Derderian, DO
538 N Old Woodward Ave,
Birmingham, MI 48009-5375
Ph: (248) 594-3091 |
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