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

Jenna Eliz Tan Derivera, CAA

Individual provider Anesthesiologist Assistant · NPI 1255123345

Jenna Eliz Tan Derivera, CAA is an Anesthesiology Assistant in Washington, District of Columbia. Graduated from Case Western University School of Dental Medicine in 2025, 1 year ago. Practices with Medical Faculty Associates, Inc, a 684-clinician group and accepts Medicare assignment.

Years since qualifying
1
Trained at
Case Western University School of Dental Medicine
In the registry since
2025
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Practice location Address checks out

1200 Pecan St SE
Washington, DC 20032-2652
Phone: (202) 823-4220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1255123345
Entity typeIndividual (Type 1)
GenderFemale
Credentials CAA
Sole proprietorNo
NPI enumeratedMay 22, 2025
Last updated in NPPESMay 22, 2025
Certification dateMay 22, 2025

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolCASE WESTERN UNIVERSITY SCHOOL OF DENTAL MEDICINE
Graduated 2025 (1 years in practice)
Group practice Medical Faculty Associates, Inc — 684 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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