MS. OLIVIA JULIETTE DERELLA PHD
NPI 1154801462
Psychologist - Clinical Child & Adolescent in Bronx, NY

Q: What is Olivia Derella's NPI number?

The NPI number for Olivia Derella is 1154801462. It was assigned to this individual provider in the NPPES registry on August 16, 2018.

Q: What is Olivia Derella's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Olivia Derella was last updated on September 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 August 16, 2018PECOS Enrolled

4401 BRONX BLVD FL 1, ROOM 139, BRONX, NY 10470(718) 304-7022 Get Directions Write a Review

NPPES record last updated: September 28, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 28, 2021, Aug 16, 2018 (2 updates tracked since 2018).

On this page

About Ms. Olivia Juliette Derella Phd NPPES

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

MS. OLIVIA JULIETTE DERELLA PHD (NPI 1154801462) is an individual clinical child & adolescent provider in Bronx, New York and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154801462

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameMS. OLIVIA JULIETTE DERELLACredential: PHD

Location Address4401 BRONX BLVD FL 1, ROOM 139Bronx, NY 10470-1407

Mailing Address4401 Bronx Blvd Fl 1Bronx, NY 10470-1407 · (718) 304-7022

Phone(718) 304-7022

Sole ProprietorNo

Enumeration DateAugust 16, 2018

Last NPPES UpdateSeptember 28, 20212 updates tracked since enumeration

NPPES CertifiedSeptember 28, 2021

✔ NPI 1154801462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

4401 BRONX BLVD FL 1, Bronx, NY 10470

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Olivia Juliette Derella Phd 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.

Medicare Billing Reassignment

Medicare enrollment records show Olivia Derella reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Montefiore Medical Center

1.8 mi

Anesthesiology

111 E 210TH ST
Bronx, NY 10467

Reassigned Medicare billing, New York enrollment
5,251 clinicians in this Medicare group

NPI 1063525152 (914) 378-6021

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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. RACHEL HORNE LMSW

Social Worker (Clinical)

4401 BRONX BLVD FL 1
BRONX, NY 10470

Bronx County (718) 304-7132

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 Olivia Derella's NPI number?

The NPI number for Olivia Derella is 1154801462. It was assigned to this individual provider in the NPPES registry on August 16, 2018.

Where is Olivia Derella located?

Olivia Derella practices at 4401 Bronx Blvd Fl 1 Room 139, Bronx, NY 10470. The listed phone number is (718) 304-7022.

What is Olivia Derella's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Olivia Derella enrolled in Medicare?

Yes. Olivia Derella is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Olivia Derella's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Olivia Derella reassigns Medicare benefits to Montefiore Medical Center (Bronx, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Olivia Derella's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Olivia Derella was last updated on September 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.