Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. John P. Dervan, MD

Individual provider Interventional Cardiology Physician · NPI 1871524439

Dr. John P. Dervan, MD is a Cardiovascular Disease (Cardiology) in Stony Brook, New York. Graduated from Saint Louis University School of Medicine in 1976, 50 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
50
Trained at
Saint Louis University School of Medicine
Licensed in
NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 Nicolls Rd # T-16030
Stony Brook, NY 11794-0001
Phone: (631) 444-3655
Fax: (631) 444-1054
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 166207 (NY)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 166207 (NY)

Record details

NPI number1871524439
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 5, 2006
Last updated in NPPESJanuary 25, 2022
Certification dateJanuary 25, 2022
Mailing address100 Nicolls Rd # T-16030, Stony Brook, NY 11794-8160

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1976 (50 years in practice)
Group practice Stony Brook Internists University Faculty Practice Corporation — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Stony Brook