DR. DERRON K.G. AMBROSE PH.D.
NPI 1164861233
Psychologist in St. Thomas, VI

Active since June 21, 2013PECOS Enrolled
9048 ALTON ADAMS SR DR, ST. THOMAS, VI 00802(340) 776-8311 Get Directions Write a Review

NPPES record last updated: March 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 26, 2026, Sep 21, 2022, Aug 5, 2021 (3 updates tracked since 2021).

About Dr. Derron K.g. Ambrose Ph.d. NPPES

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

DR. DERRON K.G. AMBROSE PH.D. (NPI 1164861233) is an individual psychologist in St. Thomas, Virgin Islands, licensed in Washington (PY60949800) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1164861233
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. DERRON K.G. AMBROSECredential: PH.D.
Location Address9048 ALTON ADAMS SR DRSt. Thomas, VI 00802
Mailing AddressPo Box 600205St Thomas, VI 00801-6205 · (340) 776-8311
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJune 21, 2013
Last NPPES UpdateMarch 26, 20263 updates tracked since enumeration
NPPES CertifiedMarch 26, 2026
✔ NPI 1164861233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in WA · PY60949800
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PY60949800 (WA), 22-047-PSY (VI)

Secondary Practice Locations 2

Location 15316 Yacht Haven Grande, Suite S 104 MB 61St. Thomas, VI 00802 · Phone (340) 715-6463
Location 29003 Havensight Mall, Suite 317St. Thomas, VI 00802 · Phone (340) 777-7735

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Derron K.g. Ambrose Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183009673
PECOS Enrollment IDI20220920001622
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 Reassignments

2

Medicare enrollment records show Derron Ambrose reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Physical Therapist
6115 ESTATE SMITH BAY UNIT 5
St Thomas, VI 00802
  • Reassigned Medicare billing, U.S. Virgin Islands enrollment
  • 9 clinicians in this Medicare group
General Acute Care Hospital
9048 SUGAR ESTATE
St Thomas, VI 00802
  • Reassigned Medicare billing, U.S. Virgin Islands enrollment
  • 114 clinicians in this Medicare group

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

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 Derron Ambrose's NPI number?

The NPI number for Derron Ambrose is 1164861233. It was assigned to this individual provider in the NPPES registry on June 21, 2013.

Where is Derron Ambrose located?

Derron Ambrose practices at 9048 Alton Adams Sr Dr, St. Thomas, VI 00802. The listed phone number is (340) 776-8311.

What is Derron Ambrose's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Derron Ambrose enrolled in Medicare?

Yes. Derron Ambrose is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Derron Ambrose's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derron Ambrose reassigns Medicare benefits to 2 organizations: Synergy Fitness And Wellness Center LLC (St Thomas, VI) and Vi Government Hospital And Health Facilities Corp (St Thomas, VI). Each 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 Derron Ambrose'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 Derron Ambrose was last updated on March 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.