SUSAN KAY DERRICKSON NP-BC
NPI 1104691153
Nurse Practitioner in Goshen, IN
About Susan Kay Derrickson Np-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUSAN KAY DERRICKSON NP-BC (NPI 1104691153) is an individual nurse practitioner in Goshen, Indiana, licensed in Indiana (71014637A) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Accepted 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
Susan Kay Derrickson Np-bc 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46528 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
GOSHEN, IN 46528
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 Susan Derrickson's NPI number?
The NPI number for Susan Derrickson is 1104691153. It was assigned to this individual provider in the NPPES registry on November 20, 2023.
Where is Susan Derrickson located?
Susan Derrickson practices at 213 Middlebury St, Goshen, IN 46528. The listed phone number is (574) 534-3300.
What is Susan Derrickson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Susan Derrickson enrolled in Medicare?
Yes. Susan Derrickson 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.
What insurance does Susan Derrickson accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Susan Derrickson 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 Susan Derrickson was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.
# Susan Kay Derrickson, NP-BC · NPI 1104691153
Nurse Practitioner physician in Goshen, Indiana. Individual provider, active in the CMS NPPES registry since November 20, 2023.
## Identity
- **NPI:** 1104691153 (Entity type: Individual)
- **Enumerated:** November 20, 2023
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 71014637A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 213 MIDDLEBURY ST, Goshen, IN 46528-2956
- **Phone:** (574) 534-3300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** March 10, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104691153) · Data from the CMS NPPES public registry.