Matilda Dervisevic, MD
NPI 1649030768ActiveIndividual· Pediatrics· Kansas City, MO
Pediatrics (MD) in Kansas City, Missouri, licensed in MO and KS, with an NPI issued in March 2024. Enrolled in Medicare as order and referring only - pediatric medicine.
Overview
| NPI | 1649030768 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | Yes |
| NPI issued | Mar 19, 2024 |
| Last updated in NPPES | Aug 26, 2024 |
| Certified by provider | Aug 26, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | 2024024774 | MO |
| Pediatrics | 208000000X | 94-11874 | KS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Pediatric Medicine (MO) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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