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HASKELL RAY DERRYBERRY FNP
NPI 1093755704
Nurse Practitioner - Family in Granbury, TX

Active since June 08, 2006PECOS Enrolled
1322 PALUXY RD, SUITE #2, GRANBURY, TX 76048(817) 579-1642(817) 579-9926 Get Directions Write a Review

NPPES record last updated: June 19, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Haskell Ray Derryberry Fnp NPPES

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

HASKELL RAY DERRYBERRY FNP (NPI 1093755704) is an individual family provider in Granbury, Texas, licensed in Texas (582138) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093755704
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameHASKELL RAY DERRYBERRYCredential: FNP
Location Address1322 PALUXY RD, SUITE #2Granbury, TX 76048-5603
Mailing Address1322 Paluxy Rd, Suite 2Granbury, TX 76048-5603 · (817) 579-1642
Phone(817) 579-1642
Fax(817) 579-9926
Sole ProprietorNo
Enumeration DateJune 8, 2006
Last NPPES UpdateJune 19, 2008
✔ NPI 1093755704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 582138
1322 PALUXY RD, Granbury, TX 76048
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINS76610

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Haskell Ray Derryberry Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Haskell Derryberry reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Integrative Emergency Services Physician Group PA
35 mi
Emergency Medicine
1500 S MAIN ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • 328 clinicians in this Medicare group
NPI 1285922542 (817) 927-1100

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 76048 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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 2

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

LAWRENCE ROBERT HESS F.N.P.
Nurse Practitioner (Family)
1322 PALUXY RD, SUITE 2
GRANBURY, TX 76048
Hood County (817) 579-1642
HOOD COUNTY HOSPITAL DISTRICT
Clinic/Center (Primary Care)
1322 PALUXY RD, SUITE 2
GRANBURY, TX 76048
Hood County (817) 579-1642

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 Haskell Derryberry's NPI number?

The NPI number for Haskell Derryberry is 1093755704. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Where is Haskell Derryberry located?

Haskell Derryberry practices at 1322 Paluxy Rd Suite #2, Granbury, TX 76048. The listed phone number is (817) 579-1642.

What is Haskell Derryberry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Haskell Derryberry enrolled in Medicare?

Yes. Haskell Derryberry is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Haskell Derryberry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Haskell Derryberry reassigns Medicare benefits to Integrative Emergency Services Physician Group PA (Fort Worth, TX). 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 Haskell Derryberry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Haskell Derryberry was last updated on June 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.