DR. PETER KIRK DERUSSY MD
NPI 1649251174
Internal Medicine in Miamisburg, OH

Active since November 10, 2005PECOS EnrolledAccepts Medicare Assignment
2115 LEITER RD, MIAMISBURG, OH 45342(937) 384-6800(937) 384-6939 Get Directions Write a Review

NPPES record last updated: February 1, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Peter Kirk Derussy Md NPPES

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

DR. PETER KIRK DERUSSY MD (NPI 1649251174) is an individual internal medicine provider in Miamisburg, Ohio, licensed in Ohio (35 076115) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Kettering Health Greene Memorial, and is a graduate of University Of South Florida College Of Medicine (1997).

NPPES Registry Identity

NPI1649251174
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. PETER KIRK DERUSSYCredential: MD
Location Address2115 LEITER RDMiamisburg, OH 45342-3659
Mailing Address6661 Clyo RdCenterville, OH 45459-2702 · (937) 425-4000 · Fax (937) 425-4002
Fax(937) 384-6939
Sole ProprietorYes
Medical School CMSUniversity Of South Florida College Of MedicineGraduated 1997
Enumeration DateNovember 10, 2005
Last NPPES UpdateFebruary 1, 2021
NPPES CertifiedFebruary 1, 2021
NPI 1649251174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in OH · 35 076115
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2115 LEITER RD, Miamisburg, OH 45342

Other Identifiers 1

Medicaid2507184OH

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Peter Kirk Derussy Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648239483
PECOS Enrollment IDI20041007000004
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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 30-39 minutes 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
413 services211 patients
Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
154 services112 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
73 services73 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
47 services45 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
41 services41 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
18 services18 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kettering Health Greene Memorial

Acute Care Hospitals · Xenia, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number360026
Location1141 North Monroe DriveXenia, OH 45385 · Greene County
Emergency services

Kettering Health Main Campus

Acute Care Hospitals · Kettering, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360079
Location3535 Southern BoulevardKettering, OH 45429 · Montgomery County
Emergency services Birthing friendly

Kettering Health Dayton

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360133
Location405 Grand AvenueDayton, OH 45405 · Montgomery County
Birthing friendly

Kettering Health Miamisburg

Acute Care Hospitals · Miamisburg, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360239
Location4000 Miamisburg-Centerville RoadMiamisburg, OH 45342 · Montgomery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45342 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers25 claims69 services$6.31 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers13 claims13 services$1.13 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Child & Adolescent Psychiatry)
2115 LEITER RD
MIAMISBURG, OH 45342
Surgery
2115 LEITER RD, SUITE 100
MIAMISBURG, OH 45342
Internal Medicine (Endocrinology, Diabetes & Metabolism)
2115 LEITER RD
MIAMISBURG, OH 45342
Counselor (Professional)
2115 LEITER RD
MIAMISBURG, OH 45342
Internal Medicine
2115 LEITER RD
MIAMISBURG, OH 45342
Student in an Organized Health Care Education/Training Program
2115 LEITER RD
MIAMISBURG, OH 45342
Student in an Organized Health Care Education/Training Program
2115 LEITER RD
MIAMISBURG, OH 45342
Student in an Organized Health Care Education/Training Program
2115 LEITER RD
MIAMISBURG, OH 45342

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649251174, enumerated as an "individual" on November 10, 2005.

The provider is located at 2115 LEITER RD MIAMISBURG, OH 45342 and the phone number is (937) 384-6800.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.

Peter Derussy is affiliated with: KETTERING HEALTH GREENE MEMORIAL, KETTERING HEALTH MAIN CAMPUS, KETTERING HEALTH DAYTON and KETTERING HEALTH MIAMISBURG.