MEDICARE: ERIK M DEJONGHE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	16534	NV
2	207R00000X	Internal Medicine Physician	16534	NV
3	207RG0100X	Gastroenterology Physician	342151	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000973245	OTHER	IN	ANTHEM PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295711414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK M DEJONGHE MD

Provider Business Mailing Address
First Line	:	655 SIERRA ROSE DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2060
Country	:	US
Telephone Number	:	775-829-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 SIERRA ROSE DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2060
Country	:	US
Telephone Number	:	775-829-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	02/11/2026

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Directions to “ ERIK M DEJONGHE MD” Practice Location

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