DOMINIC DERENGE (D.O.) – Family Medicine Physician, NPI 1033598339

DOMINIC DERENGE (D.O.) is a healthcare provider. based in Springfield, Pennsylvania. specializing in FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. OS019248 (PA). The NPI Number for DOMINIC DERENGE (D.O.) is 1033598339

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DOMINIC DERENGE (D.O.)
NPI
1033598339
Phone
(610) 690-4490
Address
1260 E Woodland Ave
Enumeration Date
20 May 2015
Last Update Date
10 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2153023600
Graduation Year
2015 (11 years ago)
PAC ID
5395091029
Group Practice PAC ID
6103815071
Professional Enrollment ID
I20180710002962
Address ID
PA191402319PH4417XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

6,103 FAMILY PRACTICE in PA

Provider Addresses for DOMINIC DERENGE (D.O.)

  • 1260 E Woodland Ave

    Suite 200

    Springfield, PA 190643969

    Phone: (610) 690-4490

    Type: Location

  • 4417 N 6TH ST

    PHILADELPHIA, PA 191402319

    Phone: (215) 302-3600

    Type: Mailing

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: 2018-07-10

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
I20180710002962IFamily PracticePATBD

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 19064)

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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: 6103815071View full group profile
NameSpecialtyState
Family PracticePA
-PA
Mental Health CounselorPA
Nurse PractitionerPA
Nurse PractitionerPA
Internal Medicine, Pediatric MedicinePA
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerPA
Internal Medicine, Pediatric MedicinePA

Reviews

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Frequently asked questions

Does DOMINIC DERENGE (D.O.) have a public NPI I can cite?
Public records show DOMINIC DERENGE (D.O.) under NPI 1033598339.
Should I treat DOMINIC DERENGE (D.O.) as an active provider?
Patients and plans typically see DOMINIC DERENGE (D.O.) as active in the national extract.
How should patients interpret DOMINIC DERENGE (D.O.)'s specialty?
The extract shows Family Medicine Physician for DOMINIC DERENGE (D.O.). Clinical services aligned with this taxonomy classification.
What geographic area is tied to DOMINIC DERENGE (D.O.)?
DOMINIC DERENGE (D.O.) is associated with Springfield, Pennsylvania in the same public data insurers reference.
Can I export DOMINIC DERENGE (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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