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DR. JONATHAN HERBERT DERLATH DMD
NPI 1699234187
Student in an Organized Health Care Education/Training Program in Stony Brook, NY

Active since March 14, 2019PECOS Enrolled
151 WESTCHESTER HALL, STONY BROOK, NY 11794(631) 444-2557(631) 444-6013 Get Directions Write a Review

NPPES record last updated: March 14, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jonathan Herbert Derlath Dmd NPPES

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

DR. JONATHAN HERBERT DERLATH DMD (NPI 1699234187) is an individual student in an organized health care education/training program in Stony Brook, New York and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699234187
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JONATHAN HERBERT DERLATHCredential: DMD
Location Address151 WESTCHESTER HALLStony Brook, NY 11794-8711
Mailing Address151 Westchester HallStony Brook, NY 11794-8711 · (631) 444-2557 · Fax (631) 444-6013
Phone(631) 444-2557
Fax(631) 444-6013
Sole ProprietorYes
Enumeration DateMarch 14, 2019
✔ NPI 1699234187 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.
151 WESTCHESTER HALL, Stony Brook, NY 11794
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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. Jonathan Herbert Derlath Dmd 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.

MR. YI MING SHEN DMD
Student in an Organized Health Care Education/Training Program
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
YARA ABDELNABI
Dentist (General Practice)
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
DR. ALAN WONG
Student in an Organized Health Care Education/Training Program
151 WESTCHESTER HALL, STONY BROOK UNIVERSITY HOSPITAL SCHOOL OF DENTAL MEDICI
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
NABIL MOMIN DDS
Student in an Organized Health Care Education/Training Program
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
VICTORIA PHU DMD
Dentist (General Practice)
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
NICOLE BITTLINGMAIER
Student in an Organized Health Care Education/Training Program
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
JUAN PABLO MORA
Student in an Organized Health Care Education/Training Program
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557
DR. REDHA KHAN DDS
Dentist (General Practice)
151 WESTCHESTER HALL
STONY BROOK, NY 11794
Suffolk County (631) 444-2557

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 Jonathan Derlath's NPI number?

The NPI number for Jonathan Derlath is 1699234187. It was assigned to this individual provider in the NPPES registry on March 14, 2019.

Where is Jonathan Derlath located?

Jonathan Derlath practices at 151 Westchester Hall, Stony Brook, NY 11794. The listed phone number is (631) 444-2557.

What is Jonathan Derlath's specialty?

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

Is Jonathan Derlath enrolled in Medicare?

Yes. Jonathan Derlath is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jonathan Derlath was last updated on March 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.