JOSE JAVIER DERDOY MD
NPI 1396838876
Pediatrics - Pediatric Gastroenterology in Saint Louis, MO
About Jose Javier Derdoy Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOSE JAVIER DERDOY MD (NPI 1396838876) is an individual pediatric gastroenterology provider in Saint Louis, Missouri, licensed in Missouri (2007002166) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Louisville, and is a graduate of Other (1988).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jose Javier Derdoy Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jose Derdoy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Forman, ND 58032
- Reassigned Medicare billing, North Dakota enrollment
- 1,464 clinicians in this Medicare group
Jacksonville, FL 32207
- Reassigned Medicare billing, Florida enrollment
- 703 clinicians in this Medicare group
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 63141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
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 Jose Derdoy's NPI number?
The NPI number for Jose Derdoy is 1396838876. It was assigned to this individual provider in the NPPES registry on October 2, 2006.
Where is Jose Derdoy located?
Jose Derdoy practices at 615 S New Ballas Rd Children's Hospital, Ground Floor, Suite Yg220, Saint Louis, MO 63141. The listed phone number is (314) 251-5550.
What is Jose Derdoy's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.
Is Jose Derdoy enrolled in Medicare?
Yes. Jose Derdoy is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jose Derdoy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jose Derdoy reassigns Medicare benefits to 2 organizations: Sanford Medical Center Fargo (Forman, ND) and The Nemours Foundation (Jacksonville, FL). 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 Jose Derdoy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jose Derdoy accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Ambetter of Tennessee and 7 other insurers list Jose Derdoy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jose Derdoy was last updated on October 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jose Javier Derdoy, MD · NPI 1396838876
Pediatric Gastroenterology physician in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since October 2, 2006.
## Identity
- **NPI:** 1396838876 (Entity type: Individual)
- **Enumerated:** October 2, 2006
- **Primary specialty:** Pediatrics - Pediatric Gastroenterology · taxonomy 2080P0206X
- **State license:** 2007002166 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 615 S NEW BALLAS RD, CHILDREN'S HOSPITAL, GROUND FLOOR, SUITE YG220, Saint Louis, MO 63141-8221
- **Phone:** (314) 251-5550 · **Fax:** (314) 251-5552
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Sanford Medical Center Fargo (NPI 1073520003, Forman, ND); The Nemours Foundation (NPI 1265585806, Jacksonville, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1988
## Record status
- **NPPES last updated:** October 4, 2024
- **Other identifiers:** Medicaid 1396838876 (MO); Medicaid 00A730200 (CA); Medicaid 300096168 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1396838876) · Data from the CMS NPPES public registry.