Dervan Healthcare Services Llc - Medicare Primary Care in Washington, DC

Dervan Healthcare Services Llc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Washington, District Of Columbia. The current practice location for Dervan Healthcare Services Llc is 3849 Pennsylvania Ave Se, Washington, District Of Columbia. For appointments, you can reach them via phone at (301) 728-3783. The mailing address for Dervan Healthcare Services Llc is 11303 Springpark Ct, Glenn Dale, Maryland and phone number is (301) 728-3783.

Dervan Healthcare Services Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1275182560. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (301) 728-3783.

Contact Information

Dervan Healthcare Services Llc
3849 Pennsylvania Ave Se
Washington
DC 20020-1309
(301) 728-3783
Not Available

Primary Care Clinic Profile

Full NameDervan Healthcare Services Llc
SpecialityClinic/Center
Location3849 Pennsylvania Ave Se, Washington, District Of Columbia
Authorized Official Name and PositionBlanche Mokoso (FNP)
Authorized Official Contact3017283783
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dervan Healthcare Services Llc
11303 Springpark Ct
Glenn Dale
MD 20769-9611

Ph: (301) 728-3783
Dervan Healthcare Services Llc
3849 Pennsylvania Ave Se
Washington
DC 20020-1309

Ph: (301) 728-3783

NPI Details:

NPI Number1275182560
Provider Enumeration Date09/09/2019
Last Update Date09/10/2020

Medicare PECOS Information:

Medicare PECOS PAC ID6406280254
Medicare Enrollment IDO20201029000961

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Medical Identifiers

Medical identifiers for Dervan Healthcare Services Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275182560NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QP2300XClinic/center - Primary Care (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Dervan Healthcare Services Llc acts as a billing entity for following providers:
Provider NameBlanche Mokoso
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356867360
PECOS PAC ID: 7214361062
Enrollment ID: I20201029001060

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