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DERICK RENE DU VIVIER MD
NPI 1235167024
Anesthesiology in Portland, OR

Active since June 29, 2006PECOS EnrolledAccepts Medicare Assignment
84.46/100
CMS Quality Rating
3181 SW JACKSON PARK RD., PORTLAND, OR 97239(503) 494-7641 Get Directions Write a Review

NPPES record last updated: September 13, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Derick Rene Du Vivier Md NPPES

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

DERICK RENE DU VIVIER MD (NPI 1235167024) is an individual anesthesiology provider in Portland, Oregon, licensed in Oregon (24146) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Ohsu Hospital And Clinics, and is a graduate of Emory University School Of Medicine (1998).

NPPES Registry Identity

NPI1235167024
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameDERICK RENE DU VIVIERCredential: MD
Location Address3181 SW JACKSON PARK RD.Portland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park Rd, Mail Code Sjh-2Portland, OR 97239-3011 · (503) 494-7641
Phone(503) 494-7641
Sole ProprietorNo
Medical School CMSEmory University School Of MedicineGraduated 1998
Enumeration DateJune 29, 2006
Last NPPES UpdateSeptember 13, 2016
✔ NPI 1235167024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in OR · 24146
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
3181 SW JACKSON PARK RD., Portland, OR 97239
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Other Identifiers 3

Medicare ID-Type Unspecified113630
Medicare UPINH64703
Medicaid286645OR

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

Derick Rene Du Vivier Md 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 ID1254374143
PECOS Enrollment IDI20050714000895
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 2

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.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
23 services23 patients
Anesthesia for other procedure on neck area (1 year or older) 00320
Anesthesia for a procedure on the neck area is a medical service provided to ensure you remain comfortable and pain-free during the operation. It involves administering medication to numb the neck region or to induce sleep. The method chosen depends on the specific procedure and your overall health.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

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.

84.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.32
Improvement Activities40
Cost46.21

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 Derick Du Vivier's NPI number?

The NPI number for Derick Du Vivier is 1235167024. It was assigned to this individual provider in the NPPES registry on June 29, 2006.

Where is Derick Du Vivier located?

Derick Du Vivier practices at 3181 SW Jackson Park Rd., Portland, OR 97239. The listed phone number is (503) 494-7641.

What is Derick Du Vivier's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Derick Du Vivier enrolled in Medicare?

Yes. Derick Du Vivier 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.

Is Derick Du Vivier affiliated with any hospitals?

According to CMS data, Derick Du Vivier is affiliated with Ohsu Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Derick Du Vivier was last updated on September 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.