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DR. DERRICK EUGENE CUSTINO M.D.
NPI 1013097146
Family Medicine in Hillsboro, OR

Active since October 16, 2006PECOS EnrolledAccepts Medicare Assignment
19400 NW EVERGREEN PKWY, HILLSBORO, OR 97124(503) 645-2762(503) 690-5023 Get Directions Write a Review

NPPES record last updated: February 4, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Derrick Eugene Custino M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DERRICK EUGENE CUSTINO M.D. (NPI 1013097146) is an individual family medicine provider in Hillsboro, Oregon, licensed in Oregon (MD22041) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of R Franklin University Of Med & Sci/chicago Medical School (1996).

NPPES Registry Identity

NPI1013097146
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DERRICK EUGENE CUSTINOCredential: M.D.
Location Address19400 NW EVERGREEN PKWYHillsboro, OR 97124-7031
Mailing Address19400 Nw Evergreen PkwyHillsboro, OR 97124-7031 · (503) 645-2762 · Fax (503) 690-5023
Phone(503) 645-2762
Fax(503) 690-5023
Sole ProprietorNo
Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 1996
Enumeration DateOctober 16, 2006
Last NPPES UpdateFebruary 4, 2022
NPPES CertifiedFebruary 4, 2022
✔ NPI 1013097146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · MD22041
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
19400 NW EVERGREEN PKWY, Hillsboro, OR 97124
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Derrick Eugene Custino M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406946177
PECOS Enrollment IDI20071218000465
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Derrick Custino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beaverton Rehab & Specialty Care, LLC
5.8 mi
Skilled Nursing Facility
11850 SW ALLEN BLVD
Beaverton, OR 97005
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
  • Also billed through NPI 1184786527 (Washington)
  • 3,207 clinicians in this Medicare group
NPI 1366469330 (503) 646-7164

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELLEY SOBEL MSW
Social Worker
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 690-5038
DANIELLE LORRAINE GESSFORD RD,CDCES,LD, CD
Dietitian, Registered
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 617-2328
JESSAMINE MICHELLE MAIBEN
Technician/Technologist (Contact Lens)
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 690-5005
DR. ELIZABETH GRACE LILES M.D.
Internal Medicine
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 813-2000
MS. JANET L LEINO LDO
Technician/Technologist (Contact Lens)
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 690-5005
DR. STEVEN LEWIS GORDON M.D.
Internal Medicine
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 645-2762
DR. TERANCE GEORGE KORDASH MD
Internal Medicine
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 813-0377
BONNIE NG PHARM D
Pharmacist
19400 NW EVERGREEN PKWY
HILLSBORO, OR 97124
Washington County (503) 690-5001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Custino's NPI number?

The NPI number for Derrick Custino is 1013097146. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Where is Derrick Custino located?

Derrick Custino practices at 19400 NW Evergreen Pkwy, Hillsboro, OR 97124. The listed phone number is (503) 645-2762.

What is Derrick Custino's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Derrick Custino enrolled in Medicare?

Yes. Derrick Custino is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Derrick Custino's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derrick Custino reassigns Medicare benefits to Beaverton Rehab & Specialty Care, LLC (Beaverton, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Derrick Custino's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derrick Custino accept?

Health plans from Kaiser Permanente list Derrick Custino as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derrick Custino was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.