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DEREK DONOVAN PA-C
NPI 1417324930
Physician Assistant in Moodus, CT

Active since September 01, 2015PECOS Enrolled
27 WILLIAM F PALMER RD, MOODUS, CT 06469(860) 873-1414(860) 358-8659 Get Directions Write a Review

NPPES record last updated: April 12, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 12, 2017, Oct 19, 2016 (2 updates tracked since 2016).

About Derek Donovan Pa-c NPPES

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

DEREK DONOVAN PA-C (NPI 1417324930) is an individual physician assistant in Moodus, Connecticut, licensed in Connecticut (003652) and active in the NPI registry since September 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417324930
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDEREK DONOVANCredential: PA-C
Location Address27 WILLIAM F PALMER RDMoodus, CT 06469-1132
Mailing Address28 Crescent StMiddletown, CT 06457-3654 · (860) 358-4820 · Fax (860) 358-8661
Phone(860) 873-1414
Fax(860) 358-8659
Sole ProprietorNo
Enumeration DateSeptember 1, 2015
Last NPPES UpdateApril 12, 20172 updates tracked since enumeration
✔ NPI 1417324930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in CT · 003652✔ Licensed in NC · 0010-05911
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.
27 WILLIAM F PALMER RD, Moodus, CT 06469
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Donovan Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06469 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

Other Providers at the Same Location NPPES 3

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

DANIEL A HENRIQUEZ M.D.
Family Medicine
27 WILLIAM F PALMER RD
MOODUS, CT 06469
Lower Connecticut River Valley Planning Region (860) 358-5220
DR. ERIC FISHER D.O.
Family Medicine
27 WILLIAM F PALMER RD
MOODUS, CT 06469
Lower Connecticut River Valley Planning Region (860) 358-5220
MHS PRIMARY CARE INC
Family Medicine
27 WILLIAM F PALMER RD
MOODUS, CT 06469
Lower Connecticut River Valley Planning Region (860) 873-1414

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 Donovan's NPI number?

The NPI number for Derek Donovan is 1417324930. It was assigned to this individual provider in the NPPES registry on September 1, 2015.

Where is Derek Donovan located?

Derek Donovan practices at 27 William F Palmer Rd, Moodus, CT 06469. The listed phone number is (860) 873-1414.

What is Derek Donovan's specialty?

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

Is Derek Donovan enrolled in Medicare?

Yes. Derek Donovan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derek Donovan was last updated on April 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.