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

Q: 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.

Q: What is J Brederson's specialty?

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

Q: 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.

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: August 30, 2026.

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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

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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)

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.

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.

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