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KELLI LINN DERRAH
NPI 1437766862
Pediatrics in Sacramento, CA

Active since September 29, 2020PECOS Enrolled
1020 29TH ST STE 480, SACRAMENTO, CA 95816(916) 733-3777(916) 454-6780 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 6, 2025, Sep 29, 2020 (2 updates tracked since 2020).

About Kelli Linn Derrah NPPES

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

KELLI LINN DERRAH (NPI 1437766862) is an individual pediatrics provider in Sacramento, California, licensed in California (A188781) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Portland, and is a graduate of Oregon Health Sciences University School Of Medicine (2022).

NPPES Registry Identity

NPI1437766862
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameKELLI LINN DERRAH
Location Address1020 29TH ST STE 480Sacramento, CA 95816-5173
Mailing AddressPo Box 255228Sacramento, CA 95865-5228 · (800) 470-0071 · Fax (916) 854-6769
Phone(916) 733-3777
Fax(916) 454-6780
Sole ProprietorNo
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2022
Enumeration DateSeptember 29, 2020
Last NPPES UpdateAugust 6, 20252 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
✔ NPI 1437766862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A188781
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1020 29TH ST STE 480, Sacramento, CA 95816
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Secondary Practice Location 1

Location 13181 SW Sam Jackson Park RdPortland, OR 97239-3011 · Phone (503) 550-6141

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelli Linn Derrah is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5496114795
PECOS Enrollment IDI20250805003858
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 95816 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

AMARDEEP SINGH BHATTI
Family Medicine
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
DR. KATHERINE PEROFSKY MD
Hospitalist
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
FRESHTA OBAIDI MD
Family Medicine
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
JACOB HARRISON ALEXANDER M.D.
Internal Medicine
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
JULIANNE TONDRE
Internal Medicine
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
NOSHERWAN ZAHID MD
Internal Medicine
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
MARK BURNISTON M.D.
Hospitalist
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 733-3777
DR. AMARDEEP SINGH AHLUWALIA MD
Pediatrics (Neonatal-Perinatal Medicine)
1020 29TH ST STE 480
SACRAMENTO, CA 95816
Sacramento County (916) 887-0780

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 Kelli Derrah's NPI number?

The NPI number for Kelli Derrah is 1437766862. It was assigned to this individual provider in the NPPES registry on September 29, 2020.

Where is Kelli Derrah located?

Kelli Derrah practices at 1020 29th St Ste 480, Sacramento, CA 95816. The listed phone number is (916) 733-3777.

What is Kelli Derrah's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kelli Derrah enrolled in Medicare?

Yes. Kelli Derrah is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelli Derrah was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.