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GEORGE DERK MD
NPI 1376201749
Family Medicine in Portland, OR

Active since December 02, 2021PECOS EnrolledAccepts Medicare Assignment
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-8311 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 29, 2026, Dec 2, 2021 (2 updates tracked since 2021).

About George Derk Md NPPES

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

GEORGE DERK MD (NPI 1376201749) is an individual family medicine provider in Portland, Oregon, licensed in Oregon (PG225734) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Sandy, and is a graduate of Oregon Health Sciences University School Of Medicine (2023).

NPPES Registry Identity

NPI1376201749
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameGEORGE DERKCredential: MD
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address36860 Industrial WaySandy, OR 97055-7371
Phone(503) 494-8311
Sole ProprietorYes
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2023
Enumeration DateDecember 2, 2021
Last NPPES UpdateJune 17, 20262 updates tracked since enumeration
NPPES CertifiedJune 17, 2026
✔ NPI 1376201749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · PG225734
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Secondary Practice Location 1

Location 136860 Industrial WaySandy, OR 97055-7371 · Phone (503) 826-0206

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

George Derk 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 ID4284094665
PECOS Enrollment IDI20260629004242
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 Reassignment

Medicare enrollment records show George Derk reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Legacy Clinics LLC
2.3 mi
Clinic/Center
1130 NW 22ND AVE STE 220
Portland, OR 97210
  • Reassigned Medicare billing, Oregon enrollment
  • 1,248 clinicians in this Medicare group
NPI 1902827272 (503) 413-2901

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

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.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 George Derk's NPI number?

The NPI number for George Derk is 1376201749. It was assigned to this individual provider in the NPPES registry on December 2, 2021.

Where is George Derk located?

George Derk practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8311.

What is George Derk's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is George Derk enrolled in Medicare?

Yes. George Derk 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 organization bills Medicare for George Derk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), George Derk reassigns Medicare benefits to Legacy Clinics LLC (Portland, OR). The 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 George Derk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does George Derk accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list George Derk as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for George Derk was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.