Dr. Michelle Derello Jardon-Aites, MD

Pediatrics, Developmental - Behavioral Pediatrics in Portsmouth, VA. Individual provider (NPI-1).

NPI number1881914331

StatusActive

Last updated in NPPESSep 8, 2023

Details

NPI: 1881914331
Entity type: Individual (NPI-1)
Name: Dr. Michelle Derello Jardon-Aites
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: Jun 7, 2010
Certification date: Sep 8, 2023
Last updated: Sep 8, 2023

Medicare and OIG

Medicare enrolled (PECOS): Yes · ORDER AND REFERRING ONLY - PEDIATRIC MEDICINE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2080P0006X	Pediatrics, Developmental - Behavioral Pediatrics	0101250180	VA	Yes

Practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Phone 757-953-5000

Mailing address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Other practice locations

9040 Jackson Ave
Tacoma, WA 98431-8800

Phone 360-257-9782 · Fax 360-257-9662

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Developmental - Behavioral Pediatrics Physician providers in Portsmouth, VA

All 8 Developmental - Behavioral Pediatrics Physician providers in Portsmouth · All 3,843 providers in Portsmouth

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