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CAROLLE M DERRADJI
NPI 1265033385
Nurse Practitioner - Family in Chicago, IL

Active since November 04, 2020PECOS Enrolled
3256 W POTOMAC AVE, CHICAGO, IL 60651(708) 280-6164 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Carolle M Derradji NPPES

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

CAROLLE M DERRADJI (NPI 1265033385) is an individual family provider in Chicago, Illinois, licensed in Illinois (209.022245) and active in the NPI registry since November 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265033385
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCAROLLE M DERRADJI
Location Address3256 W POTOMAC AVEChicago, IL 60651-2411
Mailing Address3256 W Potomac AveChicago, IL 60651-2411
Phone(708) 280-6164
Sole ProprietorYes
Enumeration DateNovember 4, 2020
NPPES CertifiedNovember 4, 2020
✔ NPI 1265033385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.022245
3256 W POTOMAC AVE, Chicago, IL 60651
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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)

Carolle M Derradji 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 Reassignments

3

Medicare enrollment records show Carolle Derradji reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Stillwater Health PLLC
Same address
Addiction Medicine
3256 W POTOMAC AVE
Chicago, IL 60651
  • Reassigned Medicare billing, Illinois enrollment
NPI 1891642179 (708) 280-6164
Pcc Community Wellness Center
3.6 mi
Federally Qualified Health Center (FQHC)
14 LAKE ST
Oak Park, IL 60302
  • Reassigned Medicare billing, Illinois enrollment
  • 221 clinicians in this Medicare group
NPI 1871516799 (708) 383-0113
Howard Brown Health Center
4.1 mi
Federally Qualified Health Center (FQHC)
2800 N SHERIDAN RD STE 211
Chicago, IL 60657
  • Reassigned Medicare billing, Illinois enrollment
  • 143 clinicians in this Medicare group
NPI 1417473851 (773) 388-1600

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60651 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

STILLWATER HEALTH PLLC
Family Medicine (Addiction Medicine)
3256 W POTOMAC AVE
CHICAGO, IL 60651
Cook County (708) 280-6164

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 Carolle Derradji's NPI number?

The NPI number for Carolle Derradji is 1265033385. It was assigned to this individual provider in the NPPES registry on November 4, 2020.

Where is Carolle Derradji located?

Carolle Derradji practices at 3256 W Potomac Ave, Chicago, IL 60651. The listed phone number is (708) 280-6164.

What is Carolle Derradji's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carolle Derradji enrolled in Medicare?

Yes. Carolle Derradji is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Carolle Derradji's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolle Derradji reassigns Medicare benefits to 3 organizations: Stillwater Health PLLC (Chicago, IL), Pcc Community Wellness Center (Oak Park, IL) and Howard Brown Health Center (Chicago, IL). Each 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 Carolle Derradji'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 Carolle Derradji was last updated on November 4, 2020. 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.