DR. DEREK WALTER NICKERSON M.D.
NPI 1265895619
Dermatology - MOHS-Micrographic Surgery in San Diego, CA

Q: What is Derek Nickerson's NPI number?

The NPI number for Derek Nickerson is 1265895619. It was assigned to this individual provider in the NPPES registry on April 2, 2016.

Q: What is Derek Nickerson's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Q: When was this NPI record last updated?

The NPPES record for Derek Nickerson was last updated on May 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since April 02, 2016PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

5550 CARMEL MOUNTAIN RD, SAN DIEGO, CA 92130(858) 943-2540 Get Directions Write a Review

NPPES record last updated: May 18, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 18, 2025, Jun 8, 2021, Jun 19, 2019 and 2 more (5 updates tracked since 2016).

On this page

About Dr. Derek Walter Nickerson M.d. NPPES

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

DR. DEREK WALTER NICKERSON M.D. (NPI 1265895619) is an individual mohs-micrographic surgery provider in San Diego, California, licensed in California (A171167) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of New York Medical College (2016).

NPPES Registry Identity

NPI1265895619

Entity TypeIndividualMale

Primary Taxonomy207ND0101X

Provider Legal NameDR. DEREK WALTER NICKERSONCredential: M.D.

Location Address5550 CARMEL MOUNTAIN RDSan Diego, CA 92130-4853

Mailing Address5550 Carmel Mountain RdSan Diego, CA 92130-4853 · (858) 943-2540

Phone(858) 943-2540

Sole ProprietorYes

Medical School CMSNew York Medical CollegeGraduated 2016

Enumeration DateApril 2, 2016

Last NPPES UpdateMay 18, 20255 updates tracked since enumeration

NPPES CertifiedMay 18, 2025

✔ NPI 1265895619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in CA · A171167

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

5550 CARMEL MOUNTAIN RD, San Diego, CA 92130

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Derek Walter Nickerson 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 ID3072888494

PECOS Enrollment IDI20210712000833

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

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

Coastal Skin And Eye Institute, Inc.

3.5 mi

Dermatology

5550 CARMEL MOUNTAIN ROAD, SUITE 206
San Diego, CA 92130

Reassigned Medicare billing, California enrollment
9 clinicians in this Medicare group

NPI 1790232015 (858) 943-2540

Grossmont Dermatology Medical Clinic

15 mi

Procedural Dermatology

8860 CENTER DR, STE 300
La Mesa, CA 91942

Reassigned Medicare billing, California enrollment
14 clinicians in this Medicare group

NPI 1194838441 (619) 462-1670

Csi Medical Group

85 mi

MOHS-Micrographic Surgery

1360 W 6TH ST STE 370
San Pedro, CA 90732

Reassigned Medicare billing, California enrollment
179 clinicians in this Medicare group

NPI 1871909804 (310) 519-8890

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

Areas of Expertise CMS Part B claims 43

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.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

1,879 services288 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

800 services509 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

640 services401 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

432 services297 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

267 services223 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks 17311

This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.

227 services181 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

118 services24 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

110 services96 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks 17312

This procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.

105 services78 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

86 services54 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

77 services77 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

74 services68 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

66 services57 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

60 services54 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

58 services44 patients

Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks 17313

This procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.

58 services50 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm 11301

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

48 services44 patients

Shaving of skin growth of body, arms, or legs, 0.5 cm or less 11300

This is a simple procedure where a small skin growth on your body, arms, or legs, measuring 0.5 cm or less, is carefully shaved off. It's typically quick, with minimal discomfort. It helps to prevent any potential health issues related to the growth.

43 services40 patients

Application of light with debridement to destroy precancer skin growth 96574

This procedure involves applying a special light source to the skin after removing dead tissue (debridement). The light helps destroy precancerous growths, preventing them from developing into skin cancer. It's a safe and effective method to keep your skin healthy.

42 services28 patients

Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) J7308

Aminolevulinic Acid HCL is a medication applied to the skin to treat certain types of skin conditions. It works by making the skin more sensitive to light, which helps to kill abnormal skin cells. The 20% solution is a single dose of 354 mg.

42 services28 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

41 services36 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

39 services39 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

38 services14 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less 11305

This is a procedure where a small skin growth on the scalp, neck, hands, or feet, measuring 0.5 cm or less, is carefully removed. The process involves shaving off the growth layer by layer to ensure complete removal. It's a safe and common practice.

36 services31 patients

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm 17261

This procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.

32 services28 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

28 services28 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

27 services25 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm 12042

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

26 services26 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less 11310

This procedure involves the careful removal of a small skin growth on the face or related areas. A medical professional uses a special tool to gently shave off the growth, which is 0.5 cm or less. It's a common, safe procedure.

25 services23 patients

Biopsy of ear 69100

A biopsy of the ear is a medical procedure where a small sample of tissue is taken from your ear for examination. This helps doctors diagnose any abnormalities or diseases. It's a simple process, usually done under local anesthesia, and has minimal risks.

25 services24 patients

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less 15260

A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.

22 services22 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

21 services20 patients

Injection into skin growth, 1-7 growths 11900

This procedure involves injecting medication into 1-7 skin growths. The medication helps to reduce the size of the growths or completely eliminate them. It's a simple, quick, and usually painless process performed by a medical professional.

20 services16 patients

Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks 17314

This procedure involves removing growths from the trunk, arms, or legs. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any abnormalities. This aids in diagnosing and treating your condition effectively.

20 services17 patients

Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm 11302

This procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.

18 services17 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

17 services15 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less 14040

This procedure involves repairing a wound on various body parts by transferring skin from another area. The transferred skin, up to 10.0 sq cm, helps to cover the wound, promoting healing and reducing scarring. It's a common method for treating larger or deeper wounds.

17 services17 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm 12034

This procedure involves the repair of a moderate-sized wound (7.6-12.5 cm) on the scalp, underarms, trunk, arms, or legs. It includes cleaning, removing damaged tissue, and stitching the wound to promote healing. Local anesthesia is used for comfort.

16 services15 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 11311

This procedure involves removing a small skin growth on the face or related areas like the ears, eyelids, nose, lips, or mouth. The growth is gently shaved off, typically under local anesthesia. It's a quick, safe process for growths between 0.6-1.0 cm in size.

15 services14 patients

Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm 17271

This procedure involves the removal of a small cancerous skin growth, between 0.6 to 1.0 cm, located on the scalp, neck, hands, or feet. The aim is to eliminate the cancerous cells and prevent their spread. The treatment is done in a safe, controlled environment.

15 services14 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

13 services12 patients

Simple or single drainage of skin abscess 10060

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

12 services12 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm 11603

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92130 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

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.

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Other Providers at the Same Location NPPES

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

NAJMEH HANNANVASH DDS, INC

Dentist (Pediatric Dentistry)

5550 CARMEL MOUNTAIN RD, 200
SAN DIEGO, CA 92130

San Diego County (619) 630-4000

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 Nickerson's NPI number?

The NPI number for Derek Nickerson is 1265895619. It was assigned to this individual provider in the NPPES registry on April 2, 2016.

Where is Derek Nickerson located?

Derek Nickerson practices at 5550 Carmel Mountain Rd, San Diego, CA 92130. The listed phone number is (858) 943-2540.

What is Derek Nickerson's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Derek Nickerson enrolled in Medicare?

Yes. Derek Nickerson 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.

Which organizations bill Medicare for Derek Nickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Nickerson reassigns Medicare benefits to 3 organizations: Coastal Skin And Eye Institute, Inc. (San Diego, CA), Grossmont Dermatology Medical Clinic (La Mesa, CA) and Csi Medical Group (San Pedro, CA). 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 Derek Nickerson'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 Derek Nickerson was last updated on May 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.