COURTNEY DERUS – Psychologist, NPI 1255765335

COURTNEY DERUS is a healthcare provider. based in Wausau, Wisconsin. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. 3605-57 (WI). The NPI Number for COURTNEY DERUS is 1255765335

Main info

Female
9 Years Of Experience
Name
COURTNEY DERUS
NPI
1255765335
Phone
(715) 845-7175
Address
114 GRAND AVE
Enumeration Date
26 August 2013
Last Update Date
2 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7158457175
Graduation Year
2017 (9 years ago)
PAC ID
4284978347
Group Practice PAC ID
1355880329
Professional Enrollment ID
I20181130002166
Address ID
WI544036214WA114XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

670 CLINICAL PSYCHOLOGIST in WI

Provider Addresses for COURTNEY DERUS

  • 114 GRAND AVE

    WAUSAU, WI 544036214

    Phone: (715) 845-7175

    Fax: (715) 845-7142

    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: 2018-11-30

PECOS data refreshed: 2026-06-15

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
I20181130002166IClinical PsychologistWITBD

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 54403)

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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: 1355880329View full group profile
NameSpecialtyState
Clinical PsychologistWI
Clinical Social WorkerWI
Clinical PsychologistWI
Mental Health CounselorWI
Clinical PsychologistWI

Reviews

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Frequently asked questions

What federal number belongs to COURTNEY DERUS?
The federal identifier for COURTNEY DERUS is NPI 1255765335.
Is COURTNEY DERUS active in the national directory?
COURTNEY DERUS's public NPI profile is in an active state.
Does COURTNEY DERUS list a primary specialty?
If you are matching referrals, note Psychologist for COURTNEY DERUS. Clinical services aligned with this taxonomy classification.
What location shows for COURTNEY DERUS?
We surface Wausau, Wisconsin for COURTNEY DERUS based on available NPPES addresses.
Is COURTNEY DERUS a real provider?
This page reflects official NPPES data for NPI 1255765335. Always confirm identity and privileges with the practice and licensing boards.

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