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DR. GRAHAM DERSNAH MD
NPI 1568038958
Student in an Organized Health Care Education/Training Program in Bridgeport, CT

Active since May 27, 2021PECOS Enrolled
267 GRANT STREET, DEPARTMENT OF OBSTETRICS & GYNECOLOGY, BRIDGEPORT, CT 06610(203) 384-3990 Get Directions Write a Review

NPPES record last updated: September 18, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 18, 2021, May 27, 2021 (2 updates tracked since 2021).

About Dr. Graham Dersnah Md NPPES

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

DR. GRAHAM DERSNAH MD (NPI 1568038958) is an individual student in an organized health care education/training program in Bridgeport, Connecticut and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568038958
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. GRAHAM DERSNAHCredential: MD
Location Address267 GRANT STREET, DEPARTMENT OF OBSTETRICS & GYNECOLOGYBridgeport, CT 06610
Mailing Address267 Grant Street, Department Of Obstetrics And GynecologyBridgeport, CT 06610 · (203) 384-3990
Phone(203) 384-3990
Sole ProprietorNo
Enumeration DateMay 27, 2021
Last NPPES UpdateSeptember 18, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2021
✔ NPI 1568038958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

267 GRANT STREET, Bridgeport, CT 06610
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Graham Dersnah Md 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.

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.

MRS. MELISSA ANN SHAW PA C
Physician Assistant
267 GRANT STREET, DEPT OF PEDIATRICS
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3199
CONNECTICUT NEUROSURGICAL SPECIALISTS, P.C.
Neurological Surgery
267 GRANT STREET, SCHINE 8
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4500
MRS. KATHARINE BERNADETTE CONNOLLY MS, PA-C
Physician Assistant (Surgical)
267 GRANT STREET
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3129
DAVID L SELIGMAN PTA
Physical Medicine & Rehabilitation
267 GRANT STREET
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
SUSAN MARY PAXTON
Nurse Practitioner (Adult Health)
267 GRANT STREET
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4677
MR. FREDDY DUARTE LAU M.D.
Student in an Organized Health Care Education/Training Program
267 GRANT STREET
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3792
FRANCES DENU MD
Hospitalist
267 GRANT STREET
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4677
DR. FABRICIO MALAGUEZ WEBBER M.D.
Student in an Organized Health Care Education/Training Program
267 GRANT STREET
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3792

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 Graham Dersnah's NPI number?

The NPI number for Graham Dersnah is 1568038958. It was assigned to this individual provider in the NPPES registry on May 27, 2021.

Where is Graham Dersnah located?

Graham Dersnah practices at 267 Grant Street Department Of Obstetrics & Gynecology, Bridgeport, CT 06610. The listed phone number is (203) 384-3990.

What is Graham Dersnah's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Graham Dersnah enrolled in Medicare?

Yes. Graham Dersnah is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Graham Dersnah was last updated on September 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.