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

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: July 26, 2026.

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

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
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

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

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.

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

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.

Dentist (Pediatric Dentistry)
5550 CARMEL MOUNTAIN RD, 200
SAN DIEGO, CA 92130

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.

When was this NPI record last updated?

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