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

NPI Status: Active since January 24, 2015

Contact Information

415 N 26TH ST
SUITE 201
LAFAYETTE, IN
ZIP 47904
Phone: (765) 446-6577

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  • Individual
  • Male
  • Nurse Practitioner
  • Psychiatric/Mental Health
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About DEREK BOOTH

This page provides the complete NPI Profile along with additional information for Derek Booth, a provider established in Lafayette, Indiana with a medical specialization in Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1568852986 assigned on January 2015. The practitioner's primary taxonomy code is 363LP0808X with license number 71005314B (IN). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1568852986
Provider Name
DEREK BOOTH
Gender
Male
Entity Type
Individual
Location Address
415 N 26TH ST SUITE 201 LAFAYETTE, IN 47904
Location Phone
(765) 446-6577
Mailing Address
415 N 26TH ST SUITE 201 LAFAYETTE, IN 47904
Is Sole Proprietor?
Yes
Enumeration Date
01-24-2015
Last Update Date
01-24-2015
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A nurse practitioner (NP) like Derek Booth is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Psychiatric/Mental Health

Taxonomy Code
363LP0808X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
71005314B
License State
IN

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Gold Value ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Value+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO
  • UHC Silver Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Derek Booth is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 29 times for 15 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 47904 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.04
  • Minimum New Patient Price $53.07
  • Maximum New Patient Price $161.76
  • Average New Patient Copayment $20.51
  • Minimum New Patient Copayment $13.26
  • Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.22
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $132.22
  • Average Established Patient Copayment $23.55
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $33.05

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Documentation of Current Medications in the Medical Record 97% 3988
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 100% 1640
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Patient-Specific Education 58% 324
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 19% 405
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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access 94% 324
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 certain information.
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.YesN/A
Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
Secure Messaging 14% 324
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of High-Risk Medications in the Elderly 34% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
29
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. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1568852986, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
8
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 2 + 8 + 1 + 6 + 5 + 4 + 9 + 1 + 6 + 24 = 74

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1568852986.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Dentist (Periodontics)
415 N 26TH ST, SUITE 303
LAFAYETTE, IN 47904
Dentist (Periodontics)
415 N 26TH ST, SUITE 303
LAFAYETTE, IN 47904
Dentist (General Practice)
415 N 26TH ST, SUITE 300
LAFAYETTE, IN 47904
Dentist (Endodontics)
415 N 26TH ST, SUITE #302
LAFAYETTE, IN 47904
Clinical Nurse Specialist (Psychiatric/Mental Health, Child & Adolescent)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Psychiatry & Neurology (Psychiatry)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Psychiatry & Neurology (Psychiatry)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Psychiatry & Neurology (Psychiatry)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Psychiatry & Neurology (Psychiatry)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Psychiatry & Neurology (Psychiatry)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
415 N 26TH ST, SUITE 201
LAFAYETTE, IN 47904
Case Manager/Care Coordinator
415 N 26TH ST
LAFAYETTE, IN 47904
Psychologist (Health Service)
415 N 26TH ST
LAFAYETTE, IN 47904
Psychologist (Clinical)
415 N 26TH ST
LAFAYETTE, IN 47904
Case Manager/Care Coordinator
415 N 26TH ST
LAFAYETTE, IN 47904
Case Manager/Care Coordinator
415 N 26TH ST
LAFAYETTE, IN 47904
Psychologist (Clinical)
415 N 26TH ST
LAFAYETTE, IN 47904
Dentist (Periodontics)
415 N 26TH ST, SUITE 303
LAFAYETTE, IN 47904
Nurse Practitioner (Adult Health)
415 N 26TH ST
LAFAYETTE, IN 47904
Nurse Practitioner (Psychiatric/Mental Health)
415 N 26TH ST
LAFAYETTE, IN 47904

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568852986, enumerated as an "individual" on January 24, 2015.

The provider is located at 415 N 26TH ST SUITE 201 LAFAYETTE, IN 47904 and the phone number is (765) 446-6577.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.