ANDREW JOHN DERIDDER NP
NPI 1144009713
Nurse Practitioner - Gerontology in Indianapolis, IN

Q: What is Andrew Deridder's NPI number?

The NPI number for Andrew Deridder is 1144009713. It was assigned to this individual provider in the NPPES registry on September 25, 2023.

Q: What is Andrew Deridder's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Deridder was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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 September 25, 2023PECOS EnrolledAccepts Medicare Assignment

8111 S EMERSON AVE, INDIANAPOLIS, IN 46237(317) 528-5000 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Andrew John Deridder Np NPPES

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

ANDREW JOHN DERIDDER NP (NPI 1144009713) is an individual gerontology provider in Indianapolis, Indiana, licensed in Indiana (71015716A) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health Arnett Hospital, and maintains a secondary practice location in Monticello.

NPPES Registry Identity

NPI1144009713

Entity TypeIndividualMale

Primary Taxonomy363LG0600X

Provider Legal NameANDREW JOHN DERIDDERCredential: NP

Location Address8111 S EMERSON AVEIndianapolis, IN 46237-8601

Mailing Address8111 S Emerson AveIndianapolis, IN 46237-8601

Phone(317) 528-5000

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 25, 2023

Last NPPES UpdateSeptember 27, 2024

NPPES CertifiedSeptember 27, 2024

✔ NPI 1144009713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in IN · 71015716A

Also ListedRegistered Nurse · EmergencyTaxonomy 163WE0003X · License 28267039A (IN)

8111 S EMERSON AVE, Indianapolis, IN 46237

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Secondary Practice Location 1

Location 1810 S 6th StMonticello, IN 47960-8201 · Phone (765) 448-8000 · Fax (574) 583-9502

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrew John Deridder Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991236754

PECOS Enrollment IDI20241003001826

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

30 services28 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Indiana University Health Arnett Hospital

Acute Care Hospitals · Lafayette, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150173

Location5165 Mccarty LnLafayette, IN 47905 · Tippecanoe County

Emergency services Birthing friendly

Indiana University Health White Memorial Hospital

Critical Access Hospitals · Monticello, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number151312

Location720 South Sixth StMonticello, IN 47960 · White County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46237 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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 20

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

JULIA PORTER MSP, CCC-SLP

Speech-Language Pathologist