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

Jose Javier Derdoy, MD

Individual provider Pediatric Gastroenterology Physician · NPI 1396838876

Jose Javier Derdoy, MD is a Pediatric Medicine in Saint Louis, Missouri. Qualified in 1988, 38 years ago. Works from 2 locations. Licensed in Kentucky and Missouri.

Years since qualifying
38
Licensed in
KY, MO
In the registry since
2006
Specialties on file
3
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

615 S New Ballas Rd Children's Hospital Ground Fl Ste YG220
Saint Louis, MO 63141-8221
Phone: (314) 251-5550
Fax: (314) 251-5552
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 231 E Chestnut St, Louisville, KY 40202-1821 — (502) 588-2330

Specialties & licences

Pediatric Gastroenterology Physician (primary) Taxonomy 2080P0206X · Licence 2007002166 (MO)
Pediatric Gastroenterology Physician Taxonomy 2080P0206X · Licence 60035 (KY)
Specialist Taxonomy 174400000X · Licence 430654872 (MO)

Record details

NPI number1396838876
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 2, 2006
Last updated in NPPESOctober 4, 2024
Certification dateOctober 4, 2024

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Also practisesGASTROENTEROLOGY
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Not indicated

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