Jose Javier Derdoy, MD in Saint Louis, MO

Jose Javier Derdoy, MD is a medicare enrolled "Pediatrics - Pediatric Gastroenterology" physician in Saint Louis, Missouri. His current practice location is 615 S New Ballas Rd, Children's Hospital, Ground Floor, Suite Yg220, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at (314) 251-5550.

Jose Javier Derdoy is licensed to practice in Missouri (license number 2007002166) 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 1396838876.

Contact Information

	Jose Javier Derdoy, MD
	615 S New Ballas Rd, Children's Hospital, Ground Floor, Suite Yg220, Saint Louis, MO 63141-8221
	(314) 251-5550
	(314) 251-5552

Map and Direction

Physician's Profile

Full Name	Jose Javier Derdoy
Gender	Male
Speciality	Pediatrics - Pediatric Gastroenterology
Location	615 S New Ballas Rd, Saint Louis, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396838876
Provider Enumeration Date: 10/02/2006
Last Update Date: 10/04/2024

Medicare PECOS Information:

PECOS PAC ID: 8820065717
Enrollment ID: I20220624001264

Medical Identifiers

Medical identifiers for Jose Javier Derdoy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396838876	NPI	-	NPPES
1396838876	Medicaid	MO
00A730200	Medicaid	CA
300096168	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0206X	Pediatrics - Pediatric Gastroenterology	60035 (Kentucky)	Secondary
174400000X	Specialist	430654872 (Missouri)	Secondary
2080P0206X	Pediatrics - Pediatric Gastroenterology	2007002166 (Missouri)	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. Jose Javier Derdoy allows following entities to bill medicare on his behalf.

Entity Name	Warren Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174582282 PECOS PAC ID: 8820900293 Enrollment ID: O20031104000252

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. Jose Javier Derdoy 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
Jose Javier Derdoy, MD 615 S New Ballas Rd, Children's Hospital, Ground Floor, Suite Yg220, Saint Louis, MO 63141-8221 Ph: (314) 251-5550	Jose Javier Derdoy, MD 615 S New Ballas Rd, Children's Hospital, Ground Floor, Suite Yg220, Saint Louis, MO 63141-8221 Ph: (314) 251-5550

Reviews and Comments

Pediatrics Doctors in Saint Louis, MO

Dr. Rachel Elizabeth Granberg, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl Msc 8116-0043-09, Saint Louis, MO 63110 Phone: 314-454-6018 Fax: 844-621-4392
Timothy J Kutz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1465 S Grand Blvd, Saint Louis, MO 63104 Phone: 314-268-6406 Fax: 314-268-2712
Dr. William L Rives, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl, Div Ped Hospitalist Med, Saint Louis, MO 63110 Phone: 314-454-2076 Fax: 314-747-8953
Dr. Linda A Tackes, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5114 Mid America Plz, Ste 2c, Saint Louis, MO 63129 Phone: 314-859-4000 Fax: 314-273-4110
Dr. Peter M Kilbridge, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Pl, Suite C, Saint Louis, MO 63110 Phone: 314-454-2479 Fax: 314-454-2524
Sarah B. Aschkenasi, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Saint Louis, MO 63110 Phone: 314-286-1264 Fax: 314-454-8869
Dr. Jeffrey Magee, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Pl, Div Ped Hematology And Onc, Ste 9s, Saint Louis, MO 63110 Phone: 314-454-6018 Fax: 844-621-4392

Jose Javier Derdoy, MD - Medicare Pediatrics in Saint Louis, MO