DEREK JAMES TRAVIS
NPI 1487038048
Student in an Organized Health Care Education/Training Program in Berkeley, CA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Derek James Travis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Derek Travis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Richmond, CA 94801
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Which organization bills Medicare for Derek Travis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Derek Travis reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, CA). 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 Derek Travis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Derek James Travis · NPI 1487038048
Student in an Organized Health Care Education/Training Program provider in Berkeley, California. Individual provider, active in the CMS NPPES registry since July 14, 2015.
## Identity
- **NPI:** 1487038048 (Entity type: Individual)
- **Enumerated:** July 14, 2015
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1621 BLAKE ST, APT 6, Berkeley, CA 94703-1865
- **Phone:** (925) 899-7964
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1235226531, Richmond, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 3, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1487038048) · Data from the CMS NPPES public registry.