AHMET DERVISH MD
NPI 1104854462
Pain Medicine - Interventional Pain Medicine in Green Bay, WI

Q: What is Ahmet Dervish's NPI number?

The NPI number for Ahmet Dervish is 1104854462. It was assigned to this individual provider in the NPPES registry on June 28, 2006. The provider is also known as Ahmet Dervisogullari MD.

Q: What is Ahmet Dervish's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Q: When was this NPI record last updated?

The NPPES record for Ahmet Dervish was last updated on August 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 28, 2006PECOS Enrolled

2845 GREENBRIER RD STE 340, GREEN BAY, WI 54311(920) 288-8380(920) 288-8385 Get Directions Write a Review

NPPES record last updated: August 29, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ahmet Dervish Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AHMET DERVISH MD (NPI 1104854462) is an individual interventional pain medicine provider in Green Bay, Wisconsin, licensed in Wisconsin (33794) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104854462

Entity TypeIndividualMale

Primary Taxonomy208VP0014X

Provider Legal NameAHMET DERVISHCredential: MD

Location Address2845 GREENBRIER RD STE 340Green Bay, WI 54311-6519

Mailing Address2845 Greenbrier Rd Ste 340, Po Box 8900Green Bay, WI 54308-8900 · (920) 288-8380 · Fax (920) 288-8385

Phone(920) 288-8380

Fax(920) 288-8385

Sole ProprietorNo

Enumeration DateJune 28, 2006

Last NPPES UpdateAugust 29, 2008

✔ NPI 1104854462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

License✔ Licensed in WI · 33794

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

2845 GREENBRIER RD STE 340, Green Bay, WI 54311

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Other Names 1

Former Name (1)Ahmet Dervisogullari Md

Other Identifiers 5

Medicaid32021400WI

Other050080452WI · Railroad

Medicare UPINF87383WI

Medicare ID-Type Unspecified013407650WI

Medicaid104365449MI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ahmet Dervish Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JULIE A BOBHOLZ PHD

Clinical Neuropsychologist

2845 GREENBRIER RD STE 340
GREEN BAY, WI 54311

Brown County (920) 288-8030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ahmet Dervish's NPI number?

The NPI number for Ahmet Dervish is 1104854462. It was assigned to this individual provider in the NPPES registry on June 28, 2006. The provider is also known as Ahmet Dervisogullari MD.

Where is Ahmet Dervish located?

Ahmet Dervish practices at 2845 Greenbrier Rd Ste 340, Green Bay, WI 54311. The listed phone number is (920) 288-8380.

What is Ahmet Dervish's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Ahmet Dervish enrolled in Medicare?

Yes. Ahmet Dervish is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ahmet Dervish was last updated on August 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.