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ROBERT A DERSHEWITZ MD
NPI 1649271412
Pediatrics in St John, IN

Active since August 03, 2005PECOS Enrolled
9660 WICKER AVENUE, 2ND FLOOR, ST JOHN, IN 46373(219) 226-2380(219) 226-2381 Get Directions Write a Review

NPPES record last updated: June 17, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Robert A Dershewitz Md NPPES

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

ROBERT A DERSHEWITZ MD (NPI 1649271412) is an individual pediatrics provider in St John, Indiana, licensed in Indiana (01051751) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649271412
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameROBERT A DERSHEWITZCredential: MD
Location Address9660 WICKER AVENUE, 2ND FLOORSt John, IN 46373-9487
Mailing Address9660 Wicker Avenue, 2nd FloorSt John, IN 46373-9487 · (219) 226-2380 · Fax (219) 226-2381
Phone(219) 226-2380
Fax(219) 226-2381
Sole ProprietorNo
Enumeration DateAugust 3, 2005
Last NPPES UpdateJune 17, 2010
✔ NPI 1649271412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IN · 01051751
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
9660 WICKER AVENUE, St John, IN 46373
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Other Identifiers 4

Medicare UPINC42643
Medicaid200254250AIN
Other000000081284IN · Anthem Bcbs
Medicare PIN150210BIN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert A Dershewitz 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.

Medicare Billing Reassignment

Medicare enrollment records show Robert Dershewitz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Care Network Inc
Same address
Family Medicine
9660 WICKER AVE
St John, IN 46373
  • Reassigned Medicare billing, Indiana enrollment
  • 607 clinicians in this Medicare group
NPI 1457610487 (219) 365-7620

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 46373 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Other Providers at the Same Location NPPES 4

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

SNEZANA BARANCYK RN FNP
Nurse Practitioner (Family)
9660 WICKER AVENUE
ST JOHN, IN 46373
Lake County (219) 365-1166
BINA K PAREKH DO
Family Medicine
9660 WICKER AVENUE
ST JOHN, IN 46373
Lake County (219) 365-1166
KIERAN L PENNING NP
Nurse Practitioner (Pediatrics)
9660 WICKER AVENUE, 2ND FLOOR
ST JOHN, IN 46373
Lake County (219) 226-2380
THOMAS MICHAEL ANGER MD
Pediatrics
9660 WICKER AVENUE, 2ND FLOOR
ST JOHN, IN 46373
Lake County (219) 226-2380

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 Robert Dershewitz's NPI number?

The NPI number for Robert Dershewitz is 1649271412. It was assigned to this individual provider in the NPPES registry on August 3, 2005.

Where is Robert Dershewitz located?

Robert Dershewitz practices at 9660 Wicker Avenue 2nd Floor, St John, IN 46373. The listed phone number is (219) 226-2380.

What is Robert Dershewitz's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Robert Dershewitz enrolled in Medicare?

Yes. Robert Dershewitz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Robert Dershewitz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Dershewitz reassigns Medicare benefits to Community Care Network Inc (St John, IN). 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 Robert Dershewitz'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 Robert Dershewitz was last updated on June 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.