DERRAL EDWARD HAWTHORNE PA-C
NPI 1295169001
Physician Assistant in Gold Beach, OR

Q: What is Derral Hawthorne's NPI number?

The NPI number for Derral Hawthorne is 1295169001. It was assigned to this individual provider in the NPPES registry on August 28, 2013.

Q: What is Derral Hawthorne's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Derral Hawthorne was last updated on March 3, 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 August 28, 2013PECOS EnrolledAccepts Medicare Assignment

94180 2ND ST, GOLD BEACH, OR 97444(541) 247-7047(541) 247-0123 Get Directions Write a Review

NPPES record last updated: March 3, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 3, 2025, Nov 29, 2018 (2 updates tracked since 2018).

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About Derral Edward Hawthorne Pa-c NPPES

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

DERRAL EDWARD HAWTHORNE PA-C (NPI 1295169001) is an individual physician assistant in Gold Beach, Oregon, licensed in Oregon (PA191287) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS, is affiliated with Bay Area Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1295169001

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameDERRAL EDWARD HAWTHORNECredential: PA-C

Location Address94180 2ND STGold Beach, OR 97444-8733

Mailing Address94180 2nd StGold Beach, OR 97444-8733 · (541) 247-3940 · Fax (541) 247-3116

Phone(541) 247-7047

Fax(541) 247-0123

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateAugust 28, 2013

Last NPPES UpdateMarch 3, 20252 updates tracked since enumeration

NPPES CertifiedMarch 3, 2025

✔ NPI 1295169001 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 OR · PA191287

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.

94180 2ND ST, Gold Beach, OR 97444

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

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

Derral Edward Hawthorne Pa-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 ID1153557897

PECOS Enrollment IDI20190214002740

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 5

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 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.

103 services79 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

96 services96 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.

44 services43 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

18 services16 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Bay Area Hospital

Acute Care Hospitals · Coos Bay, OR

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number380090

Location1775 Thompson RoadCoos Bay, OR 97420 · Coos County

Emergency services

Southern Coos Hospital & Health Center

Critical Access Hospitals · Bandon, OR

OwnershipGovernment - Hospital District or Authority

CMS Certification Number381304

Location900 11th Street SEBandon, OR 97411 · Coos County

Emergency services

Curry General Hospital

Critical Access Hospitals · Gold Beach, OR

OwnershipGovernment - Hospital District or Authority

CMS Certification Number381322

Location94220 Fourth StreetGold Beach, OR 97444 · Curry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97444 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

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.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers13 claims33 services$4.02 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier15 claims15 services$21.24 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers13 claims14 services$9.42 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier15 claims15 services$119.06 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

2 suppliers25 claims2,910 services$0.08 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier19 claims19 services$27.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

DR. REGINALD GAYLORD WILLIAMS JR. MD

Family Medicine