DEREK G KENNEASTER MD
NPI 1457372724
Dermatology in Herrin, IL

Q: What is Derek Kenneaster's NPI number?

The NPI number for Derek Kenneaster is 1457372724. It was assigned to this individual provider in the NPPES registry on July 22, 2006.

Q: What is Derek Kenneaster's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Kenneaster was last updated on March 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 July 22, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

220 N PARK AVE, SUITE 2, HERRIN, IL 62948(618) 942-3344(618) 942-5045 Get Directions Write a Review

NPPES record last updated: March 23, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Derek G Kenneaster Md NPPES

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

DEREK G KENNEASTER MD (NPI 1457372724) is an individual dermatology provider in Herrin, Illinois, licensed in Florida (ME94334) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and is a graduate of Southern Illinois University School Of Medicine (1993).

NPPES Registry Identity

NPI1457372724

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameDEREK G KENNEASTERCredential: MD

Location Address220 N PARK AVE, SUITE 2Herrin, IL 62948-3150

Mailing Address220 N Park Ave, Suite 2Herrin, IL 62948-3150 · (618) 942-3344 · Fax (618) 942-5045

Phone(618) 942-3344

Fax(618) 942-5045

Sole ProprietorNo

Medical School CMSSouthern Illinois University School Of MedicineGraduated 1993

Enumeration DateJuly 22, 2006

Last NPPES UpdateMarch 23, 2011

✔ NPI 1457372724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in FL · ME94334

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

220 N PARK AVE, Herrin, IL 62948

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Other Identifiers 7

Other65958Medicare Ptan

Medicaid036093018IL

Medicare ID-Type UnspecifiedU61452ZFL

Medicare ID-Type UnspecifiedU6145YFL

Other31057FL · Bcbs

Medicare UPING83686

Other10007459Bcbs

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

Derek G Kenneaster 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 ID9133147911

PECOS Enrollment IDI20101124000877

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 18

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.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

2,482 services304 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.

918 services479 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

645 services368 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

554 services273 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

544 services356 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

236 services196 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

208 services174 patients

Shaving of skin growth of body, arms, or legs, 0.5 cm or less 11300

This is a simple procedure where a small skin growth on your body, arms, or legs, measuring 0.5 cm or less, is carefully shaved off. It's typically quick, with minimal discomfort. It helps to prevent any potential health issues related to the growth.

143 services87 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

117 services98 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

115 services79 patients

Punch biopsy, each additional skin growth 11105

A punch biopsy is a procedure where a small, circular tool removes a sample of your skin growth. This allows for testing to identify the nature of the growth. If there are multiple growths, each additional one may also need a biopsy.

86 services61 patients

Biopsy of ear 69100

A biopsy of the ear is a medical procedure where a small sample of tissue is taken from your ear for examination. This helps doctors diagnose any abnormalities or diseases. It's a simple process, usually done under local anesthesia, and has minimal risks.

48 services40 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

30 services29 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm 11301

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

19 services15 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

19 services18 patients

Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) J7308

Aminolevulinic Acid HCL is a medication applied to the skin to treat certain types of skin conditions. It works by making the skin more sensitive to light, which helps to kill abnormal skin cells. The 20% solution is a single dose of 354 mg.

19 services14 patients

Application of light to destroy precancer skin growth 96567

This procedure involves the use of special light to eradicate precancerous skin growths. The light targets abnormal cells causing them to die off, while leaving healthy skin unharmed. It's a non-invasive method that helps prevent skin cancer.

17 services14 patients

Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm 11402

This procedure involves the removal of a noncancerous skin growth on the body, arms, or legs that is between 1.1 and 2.0 cm in size. It's a safe and routine procedure performed by a medical professional to improve your skin health and appearance.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Harrisburg Medical Center

Acute Care Hospitals · Harrisburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140210

Location100 Doctor Warren Tuttle DrHarrisburg, IL 62946 · Saline County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62948 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

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.

75/100

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

Scored as part of a group practice

Other Providers at the Same Location NPPES 6

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

MR. LEON GAUTHIER PA-C

Physician Assistant

220 N PARK AVE, SUITE 2
HERRIN, IL 62948

Williamson County (618) 942-3344

SOUTHERN ILLINOIS DERMATOLOGY, PC

Dermatology

220 N PARK AVE, SUITE 2
HERRIN, IL 62948

Williamson County (618) 942-3344

DR. TED G VAN ACKER D.O.

Dermatology

220 N PARK AVE, SUITE 2
HERRIN, IL 62948

Williamson County (618) 942-3344

MRS. SHANDA CONRAD SWAGLER F NP-C

Nurse Practitioner (Family)

220 N PARK AVE
HERRIN, IL 62948

Williamson County (618) 942-3344

NATALIE SPILLER PA-C

Physician Assistant

220 N PARK AVE
HERRIN, IL 62948

Williamson County (618) 942-3344

GERRI DYER NP

Nurse Practitioner

220 N PARK AVE, SUITE 2
HERRIN, IL 62948

Williamson County (618) 942-3344

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 Kenneaster's NPI number?

The NPI number for Derek Kenneaster is 1457372724. It was assigned to this individual provider in the NPPES registry on July 22, 2006.

Where is Derek Kenneaster located?

Derek Kenneaster practices at 220 N Park Ave Suite 2, Herrin, IL 62948. The listed phone number is (618) 942-3344.

What is Derek Kenneaster's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Derek Kenneaster enrolled in Medicare?

Yes. Derek Kenneaster 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.

Is Derek Kenneaster affiliated with any hospitals?

According to CMS data, Derek Kenneaster is affiliated with Herrin Hospital and Harrisburg Medical Center.

When was this NPI record last updated?

The NPPES record for Derek Kenneaster was last updated on March 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.