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

Individual provider Pediatrics Physician · NPI 1649030768

Matilda Dervisevic, MD is a Pediatrics Physician in Kansas City, Missouri. Practices as a sole proprietor. Licensed in Kansas and Missouri.

Licensed in
KS, MO
In the registry since
2024
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

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone: (816) 234-3000
Fax: (816) 302-9939
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 2024024774 (MO)
Pediatrics Physician Taxonomy 208000000X · Licence 94-11874 (KS)

Record details

NPI number1649030768
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 19, 2024
Last updated in NPPESAugust 26, 2024
Certification dateAugust 26, 2024

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