Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1649271412 Individual Practitioner Male Practitioner

Dr. Robert A Dershewitz , MD

Pediatrics • St John, IN

Professional Overview & Biography Verified Profile Summary

Dr. Robert Dershewitz, MD is a registered healthcare professional specializing in Pediatrics in St John, IN. Practice services are available at 9660 WICKER AVENUE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9660 Wicker Avenue
2nd Floor

St John, IN 463739487

Telephone 2192262380
Fax 2192262381
Associated Practice Facility / Clinic
🏢 St. Mary Medical Center Inc Facility NPI 1598839730

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in St John, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.8 Yrs
Regional Practice Density
2 Specialists

Practicing in St John, IN (1179 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IN 01051751

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200254250A (IN)
Commercial Insurance / Payer ID Anthem Bcbs
000000081284 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1417417544

Doctor of Osteopathic Medicine (D.O.)

Kieran Penning , NP

Nurse Practitioner - Pediatrics

NPI 1629166855

Nurse Practitioner

NPI 1912908781

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 17, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location June 17, 2010

Registered at 9660 WICKER AVENUE, 2ND FLOOR, ST JOHN, IN 463739487 (Tel: 2192262380)

📍
Updated Business Mailing Address June 17, 2010

Registered at 9660 WICKER AVENUE, 2ND FLOOR, ST JOHN, IN 463739487 (Tel: 2192262380)

👤
Provider Name / Credentials Updated June 17, 2010

Recorded as ROBERT DERSHEWITZ, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2010

Pediatrics (License #01051751 in IN)

🟢
Initial NPI Registration & Enumeration August 03, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649271412
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 03, 2005
Last Update: June 17, 2010
Sole Proprietor: No

Mailing Address

9660 Wicker Avenue, 2nd Floor

St John, IN 463739487

Phone: 2192262380

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.