GREGORY PAUL DERDERIAN (D.O.) – Vascular Surgery Physician, NPI 1457355737

GREGORY PAUL DERDERIAN (D.O.) is a healthcare provider. based in Birmingham, Michigan. specializing in VASCULAR SURGERY. They hold the professional credentials D.O.. They hold a License No. 5101007182 (MI). The NPI Number for GREGORY PAUL DERDERIAN (D.O.) is 1457355737

Main info

Male
50 Years Of Experience
Accepts Medicare Assignment
Name
GREGORY PAUL DERDERIAN (D.O.)
NPI
1457355737
Phone
(248) 594-3091
Address
538 N OLD WOODWARD AVE
Enumeration Date
2 June 2005
Last Update Date
18 September 2012

Doctor Profile

Medical School Name
KANSAS CITY COLLEGE OF MEDICINE AND SURGERY
Secondary Phone
2485943091
Graduation Year
1976 (50 years ago)
PAC ID
8426141979
Professional Enrollment ID
I20070829000825
Address ID
MI480095375BI538XXWOOD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

242 VASCULAR SURGERY in MI

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Provider Addresses for GREGORY PAUL DERDERIAN (D.O.)

  • 538, North Old Woodward Avenue, Birmingham, Oakland County, Michigan, 48009, United States

    BIRMINGHAM, MI 480095375

    Phone: (248) 594-3091

    Fax: (248) 594-3068

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2007-08-29

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
I20070829000825IVascular SurgeryMITBD

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 48009)

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Reviews

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Frequently asked questions

What NPI should I save for GREGORY PAUL DERDERIAN (D.O.)?
Save NPI 1457355737 if you need a stable reference for GREGORY PAUL DERDERIAN (D.O.).
Is GREGORY PAUL DERDERIAN (D.O.) currently active in the NPI registry?
CMS-published data lists GREGORY PAUL DERDERIAN (D.O.) as an active registrant.
What does GREGORY PAUL DERDERIAN (D.O.) treat or focus on?
Patients typically see GREGORY PAUL DERDERIAN (D.O.) under the specialty Vascular Surgery Physician. Clinical services aligned with this taxonomy classification.
Does GREGORY PAUL DERDERIAN (D.O.) practice in Michigan?
You will see Birmingham, Michigan on file for GREGORY PAUL DERDERIAN (D.O.) alongside any extra practice locations.
What if Birmingham, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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