DEREK HENDRICKSON PA-C
NPI 1043857196
Physician Assistant - Medical in Traverse City, MI

Q: What is Derek Hendrickson's NPI number?

The NPI number for Derek Hendrickson is 1043857196. It was assigned to this individual provider in the NPPES registry on December 9, 2019.

Q: What is Derek Hendrickson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Derek Hendrickson was last updated on March 15, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 09, 2019PECOS EnrolledAccepts Medicare Assignment

1200 SIXTH ST STE 200, TRAVERSE CITY, MI 49684(231) 935-5800(231) 935-5799 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 15, 2021, Dec 10, 2019 (2 updates tracked since 2019).

On this page

About Derek Hendrickson Pa-c NPPES

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

DEREK HENDRICKSON PA-C (NPI 1043857196) is an individual medical provider in Traverse City, Michigan, licensed in Michigan (5601009719) and active in the NPI registry since December 2019. He is enrolled in Medicare PECOS, is affiliated with Mymichigan Medical Center Midland, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1043857196

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameDEREK HENDRICKSONCredential: PA-C

Location Address1200 SIXTH ST STE 200Traverse City, MI 49684-2369

Mailing Address1200 Sixth St Ste 200Traverse City, MI 49684-2369 · (231) 935-5800 · Fax (231) 935-5799

Phone(231) 935-5800

Fax(231) 935-5799

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateDecember 9, 2019

Last NPPES UpdateMarch 15, 20212 updates tracked since enumeration

NPPES CertifiedMarch 15, 2021

✔ NPI 1043857196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MI · 5601009719

1200 SIXTH ST STE 200, Traverse City, MI 49684

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek Hendrickson Pa-c 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 ID2567896707

PECOS Enrollment IDI20191223000688

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

97 services69 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

93 services76 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

28 services28 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

12 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mymichigan Medical Center Midland

Acute Care Hospitals · Midland, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230222

Location4000 Wellness DriveMidland, MI 48670 · Midland County

Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Heavy duty wheelchair K0006

DME-Wheelchairs · category DD000N

1 supplier11 claims11 services$49.49 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ANNA MANION BOOHER MD

Internal Medicine (Cardiovascular Disease)