MICHELLE L. DERBIN P.A.-C.
NPI 1285721050
Physician Assistant in Lexington, KY
Active since October 05, 2006PECOS EnrolledAccepts Medicare Assignment
80.89/100
CMS Quality Rating
About Michelle L. Derbin P.a.-c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHELLE L. DERBIN P.A.-C. (NPI 1285721050) is an individual physician assistant in Lexington, Kentucky, licensed in Kentucky (PA349) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1996).
NPPES Registry Identity
NPI1285721050
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMICHELLE L. DERBINCredential: P.A.-C.
Location Address1207 S BROADWAYLexington, KY 40504-2701
Mailing Address1221 S BroadwayLexington, KY 40504-2701 · (859) 258-6200 · Fax (859) 258-6203
Phone(859) 258-8575
Fax(859) 258-8562
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateOctober 5, 2006
Last NPPES UpdateApril 8, 20252 updates tracked since enumeration
NPPES CertifiedApril 8, 2025
✔ NPI 1285721050 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 3
★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in KY · PA349
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.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA349 (KY)
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA349 (KY)
1207 S BROADWAY, Lexington, KY 40504
Other Names 1
Former Name (1)Michelle Theobald
Other Identifiers 1
Medicaid95003463KY
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
Michelle L. Derbin P.a.-c. 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 ID8628157096
PECOS Enrollment IDI20080515000447
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 7
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.
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.
107 services91 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
65 services38 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.
36 services36 patients
Injection into tendon or ligament 20550
An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
28 services17 patients
Aspiration and/or injection of fluid from medium joint 20605
This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.
21 services14 patients
Removal of bone joints between wrist and fingers 25447
This procedure involves the surgical removal of bone joints between your wrist and fingers. It's typically done to relieve pain or restore function due to conditions like arthritis. After removal, the space may be filled with a graft or artificial joint.
17 services14 patients
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 40504 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.
80.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
62.29
Promoting Interoperability
100
Improvement Activities
40
Cost
74
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
40%116 patients2/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
38%112 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
47%186 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
50%26 patients3/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
65%26 patients3/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
81%26 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%1,350 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
95%113 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%294 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
85%1,101 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
54%164 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
89%406 patients4/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
33%392 patients2/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 47 patients
87%47 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
75%1,101 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
88%1,101 patients4/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
49%1,101 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.
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.
Occupational Therapist (Hand)
1207 S BROADWAY
LEXINGTON, KY 40504
LEXINGTON, KY 40504
Physical Medicine & Rehabilitation (Pain Medicine)
1207 S BROADWAY
LEXINGTON, KY 40504
LEXINGTON, KY 40504
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 Michelle Derbin's NPI number?
The NPI number for Michelle Derbin is 1285721050. It was assigned to this individual provider in the NPPES registry on October 5, 2006. The provider is also known as Michelle Theobald.
Where is Michelle Derbin located?
Michelle Derbin practices at 1207 S Broadway, Lexington, KY 40504. The listed phone number is (859) 258-8575.
What is Michelle Derbin's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Michelle Derbin enrolled in Medicare?
Yes. Michelle Derbin 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 Michelle Derbin was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Michelle L. Derbin, P.A.-C. · NPI 1285721050
Physician Assistant physician in Lexington, Kentucky. Individual provider, active in the CMS NPPES registry since October 5, 2006.
## Identity
- **NPI:** 1285721050 (Entity type: Individual)
- **Enumerated:** October 5, 2006
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** PA349 (Kentucky)
- **Sole proprietor:** No
## Practice location
- **Address:** 1207 S BROADWAY, Lexington, KY 40504-2701
- **Phone:** (859) 258-8575 · **Fax:** (859) 258-8562
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1996
## Record status
- **NPPES last updated:** April 8, 2025
- **Other identifiers:** Medicaid 95003463 (KY)
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Source: [NPI Profile](https://npiprofile.com/npi/1285721050) · Data from the CMS NPPES public registry.