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J DEREK BREDERSON FNP
NPI 1790063162
Nurse Practitioner - Family in Port Byron, NY

Active since August 02, 2011PECOS Enrolled
60 MAIN ST, PORT BYRON, NY 13140(315) 776-9700(315) 776-9701 Get Directions Write a Review

NPPES record last updated: February 14, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About J Derek Brederson Fnp NPPES

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

J DEREK BREDERSON FNP (NPI 1790063162) is an individual family provider in Port Byron, New York, licensed in New York (336768) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790063162
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJ DEREK BREDERSONCredential: FNP
Location Address60 MAIN STPort Byron, NY 13140-0359
Mailing Address14 Maiden LnPenn Yan, NY 14527-1208 · (315) 531-9102 · Fax (315) 531-9103
Phone(315) 776-9700
Fax(315) 776-9701
Sole ProprietorNo
Enumeration DateAugust 2, 2011
Last NPPES UpdateFebruary 14, 2014
✔ NPI 1790063162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 336768
60 MAIN ST, Port Byron, NY 13140
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

J Derek Brederson Fnp 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 Reassignments

2

Medicare enrollment records show J Brederson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Western New York Medical Practice, P.C.
21 mi
General Practice
200 NORTH ST
Geneva, NY 14456
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Western New York Medical Practice PC
  • 1,030 clinicians in this Medicare group
NPI 1326446485 (315) 787-5100
Rochester General Hospital
27 mi
Internal Medicine
6692 MIDDLE RD
Sodus, NY 14551
  • Reassigned Medicare billing, New York enrollment
  • 2,285 clinicians in this Medicare group
NPI 1821163718 (315) 483-9135

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 13140 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 7

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

CHRYSTAL BEHM L.P.N.
Licensed Practical Nurse
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700
MEGHAN E HUTCHINGS FNP
Nurse Practitioner
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700
ALEXANDRIA HUDGINS
Registered Nurse
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700
MRS. SARAH-ANNE MONIQUE RINDFLEISCH RN
Registered Nurse
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700
MARGARET JENNER LPN
Licensed Practical Nurse
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700
JULIA BOYD LPN
Licensed Practical Nurse
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700
JULIE A SOULE HYG
Dental Hygienist
60 MAIN ST
PORT BYRON, NY 13140
Cayuga County (315) 776-9700

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 J Brederson's NPI number?

The NPI number for J Brederson is 1790063162. It was assigned to this individual provider in the NPPES registry on August 2, 2011.

Where is J Brederson located?

J Brederson practices at 60 Main St, Port Byron, NY 13140. The listed phone number is (315) 776-9700.

What is J Brederson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is J Brederson enrolled in Medicare?

Yes. J Brederson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for J Brederson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), J Brederson reassigns Medicare benefits to 2 organizations: Western New York Medical Practice, P.C. (Geneva, NY) and Rochester General Hospital (Sodus, NY). Each 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 J Brederson'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 J Brederson was last updated on February 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.