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DERRICK CRIPPS GALE M.D.
NPI 1548695729
Otolaryngology in Riverton, UT

Active since September 06, 2013PECOS EnrolledAccepts Medicare Assignment
93.33/100
CMS Quality Rating
4063 W 12600 S, RIVERTON, UT 84096(801) 328-2522(801) 533-0589 Get Directions Write a Review

NPPES record last updated: August 16, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 16, 2019, Jun 27, 2018 (2 updates tracked since 2018).

About Derrick Cripps Gale M.d. NPPES

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

DERRICK CRIPPS GALE M.D. (NPI 1548695729) is an individual otolaryngology provider in Riverton, Utah, licensed in Utah (11131583-1205) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS, is affiliated with Lone Peak Hospital, and maintains a secondary practice location in San Antonio.

NPPES Registry Identity

NPI1548695729
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDERRICK CRIPPS GALECredential: M.D.
Location Address4063 W 12600 SRiverton, UT 84096-7302
Mailing Address756 E 12200 SDraper, UT 84020-9724 · (801) 328-2522
Phone(801) 328-2522
Fax(801) 533-0589
Sole ProprietorNo
Medical School CMSUniversity Of Utah School Of MedicineGraduated 2013
Enumeration DateSeptember 6, 2013
Last NPPES UpdateAugust 16, 20192 updates tracked since enumeration
✔ NPI 1548695729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Licenses✔ Licensed in UT · 11131583-1205✔ Licensed in TX · R6005✔ Licensed in MO · 2013019934
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
4063 W 12600 S, Riverton, UT 84096
Open in Google Maps ↗

Secondary Practice Location 1

Location 114603 Huebner Rd Ste 101San Antonio, TX 78230 · Phone (210) 468-5426

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, BridgeSpan Health Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derrick Cripps Gale M.d. 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 ID2365779725
PECOS Enrollment IDI20190807002429
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.

Medicare Billing Reassignment

Medicare enrollment records show Derrick Gale reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Intermountain Ear,nose, And Throat Specialists LLC
16 mi
Medical Specialty
22 S 900 E
Salt Lake City, UT 84102
  • Reassigned Medicare billing, Utah enrollment
  • 31 clinicians in this Medicare group
NPI 1487764411 (801) 328-2522

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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.

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.
33 services23 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
16 services16 patients

Hospital Affiliations CMS Care Compare

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

Lone Peak Hospital

Acute Care Hospitals · Draper, UT
5/5 CMS rating
OwnershipProprietary
CMS Certification Number460060
Location11925 South State StreetDraper, UT 84020 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84096 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

93.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.66
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
2 suppliers17 claims17 services$11.11 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
3 suppliers27 claims27 services$18.70 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

ROSHELLE MARIE LEILUA HIS
Hearing Instrument Specialist
4063 W 12600 S
RIVERTON, UT 84096
Salt Lake County (801) 495-4800
CLARE NICOLAS AUD
Audiologist
4063 W 12600 S
RIVERTON, UT 84096
Salt Lake County (801) 495-4800

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 Derrick Gale's NPI number?

The NPI number for Derrick Gale is 1548695729. It was assigned to this individual provider in the NPPES registry on September 6, 2013.

Where is Derrick Gale located?

Derrick Gale practices at 4063 W 12600 S, Riverton, UT 84096. The listed phone number is (801) 328-2522.

What is Derrick Gale's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Derrick Gale enrolled in Medicare?

Yes. Derrick Gale 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.

Which organization bills Medicare for Derrick Gale's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derrick Gale reassigns Medicare benefits to Intermountain Ear,nose, And Throat Specialists LLC (Salt Lake City, UT). 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 Derrick Gale's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derrick Gale accept?

Health plans from Ambetter Health, Ambetter from Sunflower Health Plan, BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc. and Regence BlueCross BlueShield of Utah and 2 other insurers list Derrick Gale as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Derrick Gale affiliated with any hospitals?

According to CMS data, Derrick Gale is affiliated with Lone Peak Hospital.

When was this NPI record last updated?

The NPPES record for Derrick Gale was last updated on August 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.