JOSEPH A DERIJE (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1003107616

JOSEPH A DERIJE (NP) is a healthcare provider. based in Culver city, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 743245 (CA). The NPI Number for JOSEPH A DERIJE (NP) is 1003107616

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
JOSEPH A DERIJE (NP)
NPI
1003107616
Phone
(310) 945-3350
Address
9808 VENICE BLVD
Enumeration Date
29 April 2011
Last Update Date
20 June 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3109453350
Graduation Year
2016 (10 years ago)
PAC ID
6406137751
Group Practice PAC ID
2668467341
Professional Enrollment ID
I20161229000826
Address ID
CA902326824CU9808XBLVD305
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:15State licenses:2Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for JOSEPH A DERIJE (NP)

  • 9808 VENICE BLVD

    SUITE 700

    CULVER CITY, CA 902322732

    Phone: (310) 945-3350

    Fax: (310) 840-7023

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $290.

Total Amount is formed as General ($290) + Research ($0) + Ownership ($0) = $290.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($142).

Total Amount

$290

General + Research + Ownership

Payments

12

Total payment records

General Amount

$290

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-12-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161229000826INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90232)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668467341View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
Clinical Social WorkerCA
Nurse PractitionerCA
-CA
Nurse PractitionerCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Clinical Social WorkerCA
Marriage And Family TherapistCA
-CA

Reviews

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Frequently asked questions

How is JOSEPH A DERIJE (NP) identified in CMS data?
CMS-hosted NPPES data lists JOSEPH A DERIJE (NP) with NPI 1003107616.
Is JOSEPH A DERIJE (NP) listed as active for patients and plans?
The listing shows JOSEPH A DERIJE (NP) as active in the NPI system.
What is JOSEPH A DERIJE (NP)'s primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for JOSEPH A DERIJE (NP) here. Clinical services aligned with this taxonomy classification.
Where should I expect JOSEPH A DERIJE (NP) on a map?
Expect Culver City, California as a primary anchor for JOSEPH A DERIJE (NP) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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