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DERRICK LYNN JOHNSTON M.D.
NPI 1184852709
Urology - Pediatric Urology in Tucson, AZ

Active since June 23, 2009PECOS Enrolled
5166 E GLENN ST, TUCSON, AZ 85712(520) 795-5338(520) 795-5382 Get Directions Write a Review

NPPES record last updated: June 2, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Derrick Lynn Johnston M.d. NPPES

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

DERRICK LYNN JOHNSTON M.D. (NPI 1184852709) is an individual pediatric urology provider in Tucson, Arizona, licensed in Arizona (51576) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184852709
Entity TypeIndividualMale
Primary Taxonomy2088P0231X
Provider Legal NameDERRICK LYNN JOHNSTONCredential: M.D.
Location Address5166 E GLENN STTucson, AZ 85712-1337
Mailing Address5166 E Glenn StTucson, AZ 85712-1337 · (520) 795-5338 · Fax (520) 795-5382
Phone(520) 795-5338
Fax(520) 795-5382
Sole ProprietorNo
Enumeration DateJune 23, 2009
Last NPPES UpdateJune 2, 2016
✔ NPI 1184852709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrology · Pediatric UrologyAllopathic & Osteopathic Physicians
Taxonomy Code2088P0231X
License✔ Licensed in AZ · 51576
Definition
Surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele).
5166 E GLENN ST, Tucson, AZ 85712
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derrick Lynn Johnston M.d. 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 Reassignments

3

Medicare enrollment records show Derrick Johnston reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Clinics For Rehabilitative Services
0.2 mi
Multi-Specialty
2600 N WYATT DR
Tucson, AZ 85712
  • Reassigned Medicare billing, Arizona enrollment
  • 138 clinicians in this Medicare group
NPI 1063454346 (520) 324-5437
Tmc Medical Network
0.4 mi
Multi-Specialty
5301 E GRANT RD
Tucson, AZ 85712
  • Reassigned Medicare billing, Arizona enrollment
  • 471 clinicians in this Medicare group
NPI 1750832283 (520) 327-5461
Tmcone
0.4 mi
Multi-Specialty
5301 E GRANT RD
Tucson, AZ 85712
  • Reassigned Medicare billing, Arizona enrollment
  • 196 clinicians in this Medicare group
NPI 1467310417 (520) 324-2308

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

Other Providers at the Same Location NPPES 8

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

JANELLE LYN VESELY N.P.
Nurse Practitioner (Family)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
JEFFREY C HOEHNER
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
IVAN MISAEL GUTIERREZ M.D
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
CATHERINE M COSENTINO MD
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
ARTHI HANNALLAH MD
Urology (Pediatric Urology)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
ARIZONA PEDIATRIC SURGERY LTD
Specialist
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
NANCYE SOPORITO NP
Nurse Practitioner (Pediatrics, Critical Care)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
JONATHAN PAPIC
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338

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 Derrick Johnston's NPI number?

The NPI number for Derrick Johnston is 1184852709. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Where is Derrick Johnston located?

Derrick Johnston practices at 5166 E Glenn St, Tucson, AZ 85712. The listed phone number is (520) 795-5338.

What is Derrick Johnston's specialty?

The primary specialty registered for this NPI is Urology, specializing in Pediatric Urology, with taxonomy code 2088P0231X.

Is Derrick Johnston enrolled in Medicare?

Yes. Derrick Johnston is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Derrick Johnston's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derrick Johnston reassigns Medicare benefits to 3 organizations: Children's Clinics For Rehabilitative Services (Tucson, AZ), Tmc Medical Network (Tucson, AZ) and Tmcone (Tucson, AZ). 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 Derrick Johnston's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derrick Johnston accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc list Derrick Johnston 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 Derrick Johnston was last updated on June 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.