ADIEL DERKHIDAM
NPI 1538015235
Nurse Practitioner - Primary Care in Hollis, NY
About Adiel Derkhidam NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADIEL DERKHIDAM (NPI 1538015235) is an individual primary care provider in Hollis, New York, licensed in New York (3763318) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Adiel Derkhidam is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Adiel Derkhidam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Brooklyn, NY 11229
- Reassigned Medicare billing, New York enrollment
- 2 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 11423 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 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Adiel Derkhidam's NPI number?
The NPI number for Adiel Derkhidam is 1538015235. It was assigned to this individual provider in the NPPES registry on March 6, 2026.
Where is Adiel Derkhidam located?
Adiel Derkhidam practices at 19002 Jamaica Ave, Hollis, NY 11423. The listed phone number is (718) 577-2211.
What is Adiel Derkhidam's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Adiel Derkhidam enrolled in Medicare?
Yes. Adiel Derkhidam is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Adiel Derkhidam's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Adiel Derkhidam reassigns Medicare benefits to Brooklyn Cardiology, P.C. (Brooklyn, 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 Adiel Derkhidam'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 Adiel Derkhidam was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Adiel Derkhidam · NPI 1538015235
Primary Care physician in Hollis, New York. Individual provider, active in the CMS NPPES registry since March 6, 2026.
## Identity
- **NPI:** 1538015235 (Entity type: Individual)
- **Enumerated:** March 6, 2026
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 3763318 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 19002 JAMAICA AVE, Hollis, NY 11423-2034
- **Phone:** (718) 577-2211
## 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:** Brooklyn Cardiology, P.C. (NPI 1609904812, Brooklyn, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** March 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1538015235) · Data from the CMS NPPES public registry.