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PATRICIA ANN DERUSSO C.R.N.P.
NPI 1386689131
Pediatrics - Pediatric Gastroenterology in Philadelphia, PA

Active since June 17, 2006
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILA - GASTRO & NUTRITION, PHILADELPHIA, PA 19104(215) 590-3247(215) 590-3606 Get Directions Write a Review

NPPES record last updated: April 15, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Patricia Ann Derusso C.r.n.p. NPPES

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

PATRICIA ANN DERUSSO C.R.N.P. (NPI 1386689131) is an individual pediatric gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD048053L) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1386689131
Entity TypeIndividualMale
Primary Taxonomy2080P0206X
Provider Legal NamePATRICIA ANN DERUSSOCredential: C.R.N.P.
Location Address3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILA - GASTRO & NUTRITIONPhiladelphia, PA 19104-4319
Mailing Address100 E Penn Sq, 9th FloorPhiladelphia, PA 19107-3323 · (267) 425-9234 · Fax (267) 425-9299
Phone(215) 590-3247
Fax(215) 590-3606
Sole ProprietorNo
Enumeration DateJune 17, 2006
Last NPPES UpdateApril 15, 2013
✔ NPI 1386689131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
License✔ Licensed in PA · MD048053L
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Also ListedPediatricsTaxonomy 208000000X · License R114248 (MD)
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Other Identifiers 3

Medicare UPING32404MD
Medicare ID-Type UnspecifiedKR41991RMD
Medicaid510050000MD

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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Patricia Derusso's NPI number?

The NPI number for Patricia Derusso is 1386689131. It was assigned to this individual provider in the NPPES registry on June 17, 2006.

Where is Patricia Derusso located?

Patricia Derusso practices at 3401 Civic Center Blvd Children's Hospital Of Phila - Gastro & Nutrition, Philadelphia, PA 19104. The listed phone number is (215) 590-3247.

What is Patricia Derusso's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

When was this NPI record last updated?

The NPPES record for Patricia Derusso was last updated on April 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.