DEREK BOOTH
NPI 1568852986
Nurse Practitioner - Psychiatric/Mental Health in Lafayette, IN

Q: What is Derek Booth's NPI number?

The NPI number for Derek Booth is 1568852986. It was assigned to this individual provider in the NPPES registry on January 24, 2015.

Q: What is Derek Booth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Derek Booth was last updated on January 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 January 24, 2015PECOS Enrolled

415 N 26TH ST, SUITE 201, LAFAYETTE, IN 47904(765) 446-6577 Get Directions Write a Review

NPPES record last updated: January 24, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Derek Booth NPPES

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

DEREK BOOTH (NPI 1568852986) is an individual psychiatric/mental health provider in Lafayette, Indiana, licensed in Indiana (71005314B) and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568852986

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameDEREK BOOTH

Location Address415 N 26TH ST, SUITE 201Lafayette, IN 47904-2895

Mailing Address415 N 26th St, Suite 201Lafayette, IN 47904-2895

Phone(765) 446-6577

Sole ProprietorYes

Enumeration DateJanuary 24, 2015

✔ NPI 1568852986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in IN · 71005314B

415 N 26TH ST, Lafayette, IN 47904

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Booth 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.

Medicare Billing Reassignments

Medicare enrollment records show Derek Booth reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Valley Oaks Health Inc

Same address

Mental Health (Including Community Mental Health Center)

415 N 26TH STREET, SUITE 201
Lafayette, IN 47904

Reassigned Medicare billing, Indiana enrollment
93 clinicians in this Medicare group

NPI 1689629990 (765) 446-6535

State Of Indiana Auditor Of State

5.8 mi

Nursing Facility/Intermediate Care Facility

3851 N RIVER RD
West Lafayette, IN 47906

Reassigned Medicare billing, Indiana enrollment
112 clinicians in this Medicare group

NPI 1194778001 (765) 463-1502

Bloomington Meadows Gp

85 mi

Family

3600 N PROW RD
Bloomington, IN 47404

Reassigned Medicare billing, Indiana enrollment
17 clinicians in this Medicare group

NPI 1033298120 (812) 331-8000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47904 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

97%3,988 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

100%1,640 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

58%324 patients3/55-star benchmark: 99%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

19%405 patients1/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

94%324 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

14%324 patients1/55-star benchmark: 59%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 24% · 29 patients

34%29 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

DR. DAVID ALEXANDER D.D.S, M.S.D

Dentist (Periodontics)

415 N 26TH ST, SUITE 303
LAFAYETTE, IN 47904

Tippecanoe County (765) 447-9319

JUSTIN SCHMITT

Case Manager/Care Coordinator

415 N 26TH ST
LAFAYETTE, IN 47904

Tippecanoe County (765) 446-6535

AMY LIND

Case Manager/Care Coordinator

415 N 26TH ST
LAFAYETTE, IN 47904

Tippecanoe County (765) 446-6535

KYLEE SLADE

Nurse Practitioner (Psychiatric/Mental Health)

415 N 26TH ST
LAFAYETTE, IN 47904

Tippecanoe County (765) 404-3055

DIANA LYNN KING PMHNP

Nurse Practitioner (Psychiatric/Mental Health)

415 N 26TH ST
LAFAYETTE, IN 47904

Tippecanoe County (765) 446-6400

ZEINAB TOBAA MD

Psychiatry & Neurology (Psychiatry)

415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904

Tippecanoe County (765) 446-6535

DR. VERNON L LITTLE M.D.

Psychiatry & Neurology (Psychiatry)

415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904

Tippecanoe County (765) 446-6535

MRS. SALLY A PARMAN R.N

Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)

415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904

Tippecanoe County (765) 446-6535

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 Booth's NPI number?

The NPI number for Derek Booth is 1568852986. It was assigned to this individual provider in the NPPES registry on January 24, 2015.

Where is Derek Booth located?

Derek Booth practices at 415 N 26th St Suite 201, Lafayette, IN 47904. The listed phone number is (765) 446-6577.

What is Derek Booth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Derek Booth enrolled in Medicare?

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

Which organizations bill Medicare for Derek Booth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Booth reassigns Medicare benefits to 3 organizations: Valley Oaks Health Inc (Lafayette, IN), State Of Indiana Auditor Of State (West Lafayette, IN) and Bloomington Meadows Gp (Bloomington, IN). Each 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 Booth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derek Booth accept?

Health plans from Cigna Healthcare list Derek Booth 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.

When was this NPI record last updated?

The NPPES record for Derek Booth was last updated on January 24, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.