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JENNA DERICKSON
NPI 1215458120
Physician Assistant in Oakland, CA

Active since June 30, 2017PECOS Enrolled
275 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-1105 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 3, 2022, Feb 20, 2019, Jun 30, 2017 (3 updates tracked since 2017).

About Jenna Derickson NPPES

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

JENNA DERICKSON (NPI 1215458120) is an individual physician assistant in Oakland, California, licensed in California (54296) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215458120
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJENNA DERICKSON
Location Address275 W MACARTHUR BLVDOakland, CA 94611-5641
Mailing Address275 W Macarthur Blvd Fl 3Oakland, CA 94611-5641 · (510) 752-1105
Phone(510) 752-1105
Sole ProprietorNo
Enumeration DateJune 30, 2017
Last NPPES UpdateJanuary 3, 20223 updates tracked since enumeration
✔ NPI 1215458120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 54296
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
275 W MACARTHUR BLVD, Oakland, CA 94611
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenna Derickson 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94611 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
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 20

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

DR. ANNA C. MORGAN MD
Specialist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. TRANG H. LA MD
Radiology (Radiation Oncology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. AMIN MATIN M.D., M.P.H.
Radiology (Diagnostic Radiology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (925) 295-5758
SUCHETA KORWAR MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
MR. MATTHEW GABRIELSON D.P.T.
Physical Therapist (Orthopedic)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6221
MALORIE HACKER MD
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
RENEE L. PERRY DO
Obstetrics & Gynecology
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
HERPRIT KAUR MAHAL MD
Hospitalist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000

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 Jenna Derickson's NPI number?

The NPI number for Jenna Derickson is 1215458120. It was assigned to this individual provider in the NPPES registry on June 30, 2017.

Where is Jenna Derickson located?

Jenna Derickson practices at 275 W Macarthur Blvd, Oakland, CA 94611. The listed phone number is (510) 752-1105.

What is Jenna Derickson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jenna Derickson enrolled in Medicare?

Yes. Jenna Derickson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jenna Derickson was last updated on January 3, 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.