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DR. DEREK DOUGLAS M.D
NPI 1154747657
Emergency Medicine in Louisville, KY

Active since March 10, 2014PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217(502) 634-6767(502) 634-6775 Get Directions Write a Review

NPPES record last updated: August 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 10, 2022, Aug 5, 2021, Jul 20, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Derek Douglas M.d NPPES

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

DR. DEREK DOUGLAS M.D (NPI 1154747657) is an individual emergency medicine provider in Louisville, Kentucky, licensed in Kentucky (54968) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS, is affiliated with Norton Hospitals, Inc, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1154747657
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. DEREK DOUGLASCredential: M.D
Location Address1 AUDUBON PLAZA DRLouisville, KY 40217-1318
Mailing AddressPo Box 36218Louisville, KY 40233-6218 · (502) 634-6767 · Fax (502) 634-6775
Phone(502) 634-6767
Fax(502) 634-6775
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2014
Enumeration DateMarch 10, 2014
Last NPPES UpdateAugust 10, 20224 updates tracked since enumeration
NPPES CertifiedAugust 10, 2022
✔ NPI 1154747657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in KY · 54968✔ Licensed in IL · 036.156045✔ Licensed in OH · 35.128034
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 128034 (OH)
1 AUDUBON PLAZA DR, Louisville, KY 40217
Open in Google Maps ↗

Secondary Practice Locations 2

Location 14960 Norton Healthcare BlvdLouisville, KY 40241-2831 · Phone (502) 634-6767 · Fax (502) 634-6775
Location 2200 E Chestnut StLouisville, KY 40202-1831 · Phone (502) 634-6767 · Fax (502) 634-6775

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CareSource.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

Dr. Derek Douglas 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 ID3476852427
PECOS Enrollment IDI20210226002038
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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
173 services169 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
139 services138 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
48 services46 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
31 services31 patients

Hospital Affiliations CMS Care Compare

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

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40217 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

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.

COREY WARF M.D.
Emergency Medicine
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (502) 636-7225
MICHAEL DYLAN COOPER BSN, RN
Registered Nurse (Administrator)
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (606) 282-0971
DR. RANDALL JOSHUA CAMPBELL M.D.
Anesthesiology
1 AUDUBON PLAZA DR, ATTN: RUBY POLTNER
LOUISVILLE, KY 40217
Jefferson County (502) 636-7160
LAUREN FLAHERTY PA-C
Physician Assistant
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (502) 634-6767
ADAM LEHNIG MD
Emergency Medicine
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (502) 636-7255
DR. BRETT ALLEN MILLER M.D.
Emergency Medicine
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (502) 634-6767
ELVIS U NJERE D.O
Emergency Medicine
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (502) 636-7225
JACKSON GEORGE UNTERINER MD
Radiology (Diagnostic Radiology)
1 AUDUBON PLAZA DR
LOUISVILLE, KY 40217
Jefferson County (502) 447-8786

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 Derek Douglas's NPI number?

The NPI number for Derek Douglas is 1154747657. It was assigned to this individual provider in the NPPES registry on March 10, 2014.

Where is Derek Douglas located?

Derek Douglas practices at 1 Audubon Plaza Dr, Louisville, KY 40217. The listed phone number is (502) 634-6767.

What is Derek Douglas's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Derek Douglas enrolled in Medicare?

Yes. Derek Douglas 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 Derek Douglas accept?

Health plans from Blue Cross and Blue Shield of Texas and CareSource list Derek Douglas 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.

Is Derek Douglas affiliated with any hospitals?

According to CMS data, Derek Douglas is affiliated with Norton Hospitals, Inc.

When was this NPI record last updated?

The NPPES record for Derek Douglas was last updated on August 10, 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.