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DEREK JAMES TRAVIS
NPI 1487038048
Student in an Organized Health Care Education/Training Program in Berkeley, CA

Active since July 14, 2015PECOS Enrolled
1621 BLAKE ST, APT 6, BERKELEY, CA 94703(925) 899-7964 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Derek James Travis NPPES

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

DEREK JAMES TRAVIS (NPI 1487038048) is an individual student in an organized health care education/training program in Berkeley, California and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487038048
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDEREK JAMES TRAVIS
Location Address1621 BLAKE ST, APT 6Berkeley, CA 94703-1865
Mailing Address1621 Blake St Apt 6Berkeley, CA 94703-1857 · (925) 899-7964
Phone(925) 899-7964
Sole ProprietorNo
Enumeration DateJuly 14, 2015
Last NPPES UpdateJanuary 3, 2022
✔ NPI 1487038048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1621 BLAKE ST, Berkeley, CA 94703
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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 James Travis 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.

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 Travis's NPI number?

The NPI number for Derek Travis is 1487038048. It was assigned to this individual provider in the NPPES registry on July 14, 2015.

Where is Derek Travis located?

Derek Travis practices at 1621 Blake St Apt 6, Berkeley, CA 94703. The listed phone number is (925) 899-7964.

What is Derek Travis's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Derek Travis enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Derek Travis was last updated on January 3, 2022. 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.