DR. RICHARD DERBY MD
NPI 1295720845
Family Medicine - Sports Medicine in O Fallon, IL

Q: What is Richard Derby's NPI number?

The NPI number for Richard Derby is 1295720845. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Q: What is Richard Derby's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Richard Derby was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment

94.61/100

CMS Quality Rating

670 PIERCE BLVD, O FALLON, IL 62269(618) 206-2094 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Richard Derby Md NPPES

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

DR. RICHARD DERBY MD (NPI 1295720845) is an individual sports medicine provider in O Fallon, Illinois, licensed in Illinois (036126121) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with St Josephs Hospital, and is a graduate of University Of Vermont College Of Medicine (1994).

NPPES Registry Identity

NPI1295720845

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameDR. RICHARD DERBYCredential: MD

Location Address670 PIERCE BLVDO Fallon, IL 62269-2579

Mailing Address670 Pierce BlvdO Fallon, IL 62269-2579 · (618) 206-2094

Phone(618) 206-2094

Sole ProprietorNo

Medical School CMSUniversity Of Vermont College Of MedicineGraduated 1994

Enumeration DateSeptember 20, 2005

Last NPPES UpdateDecember 29, 2021

NPPES CertifiedDecember 29, 2021

✔ NPI 1295720845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in IL · 036126121

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

670 PIERCE BLVD, O Fallon, IL 62269

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware 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

Dr. Richard Derby 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 ID9436332178

PECOS Enrollment IDI20110317000893

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 10

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.

Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg J7318

Hyaluronan or derivative, Durolane, is a treatment injected directly into the joint to relieve pain and improve mobility. It's often used for arthritis in the knee. The substance works by supplementing your body's natural joint fluid to help lubricate and cushion the joint.

7,682 services59 patients

Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg J7325

Synvisc or Synvisc-One is a treatment involving an injection of a substance called hyaluronan into your joints. This substance, naturally found in the body, helps lubricate and cushion your joints, reducing pain and improving mobility. It's often used for arthritis patients.

2,976 services32 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.

997 services128 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

374 services169 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.

371 services186 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

113 services44 patients

Hospital Affiliations CMS Care Compare 2

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

St Josephs Hospital

Acute Care Hospitals · Breese, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number140145

Location9515 Holy Cross LnBreese, IL 62230 · Clinton County

Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62269 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

Most-billed visit code 99214

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.

94.61/100

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

Scored through an Alternative Payment Model

Quality

85.17

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 13

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

MRS. AMY MARIE BUCK APN

Nurse Practitioner (Family)