Individual provider

Samir Derisavifard, MD

Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Urology Physician Medicare enrolled

Samir Derisavifard, MD is an Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician in Rego Park, NY, registered under NPI 1477997690. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 9225 QUEENS BLVD FL 2, Rego Park, NY 11374. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

9225 QUEENS BLVD FL 2, Rego Park, NY 11374 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
282292-01 NY Urogynecology and Reconstructive Pelvic… primary
S5157 TX Urology Physician
282292-01 NY Urology Physician

Licences are recorded in 2 states: NY, TX. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Urology
PAC ID
8325302029
Enrollment ID
I20220915000925

Medicare enrolment is recorded as approved under the provider type Practitioner - Urology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: New York and Texas. The practice address on file is in Rego Park, NY, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

NY New York practice address
Licence
282292-01
Specialty
Urogynecology and Reconstructive Pelvic…
Verify with the NY board →
TX Texas
Licence
S5157
Specialty
Urology Physician
Verify with the TX board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Urogynecology and Reconstructive Pelvic Surgery covers

A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. NUCC Health Care Provider Taxonomy, code 2088F0040X
Allopathic & Osteopathic Physicians Urology Urogynecology and Reconstructive Pelvic Surgery

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
2088F0040X Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Urogynecology and Reconstructive Pelvic Surgery 282292-01 NY primary
208800000X Urology Physician S5157 TX
208800000X Urology Physician 282292-01 NY

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1477997690 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 18, 2013
Last updatedJun 12, 2024
StatusActive
Sole proprietorNo
CredentialMD
Practice address 9225 QUEENS BLVD FL 2
Rego Park, NY 11374
(817) 925-6200
This record was updated on Jun 12, 2024, which is recent enough that the contact details are likely still accurate.

Number check

1477997690 passes the NPI check digit test The final digit 0 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 4 7 7 9 9 7 6 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 4 5 7 9 9 5 6 9

Sum = 80 · next multiple of 10 = 80 · check digit = 0 · actual last digit = 0

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1477997690?
NPI 1477997690 is the National Provider Identifier assigned to Samir Derisavifard, MD in Rego Park, NY. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Urogynecology and Reconstructive Pelvic Surgery cover?
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic…
How do I contact Samir Derisavifard, MD?
The phone number on file with NPPES is (817) 925-6200, last updated Jun 12, 2024. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Samir Derisavifard, MD accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1477997690 a valid number?
Yes. 1477997690 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.