DERRIK JAMES DOTTER DO
NPI 1659168508
Student in an Organized Health Care Education/Training Program in Mesa, AZ
About Derrik James Dotter Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERRIK JAMES DOTTER DO (NPI 1659168508) is an individual student in an organized health care education/training program in Mesa, Arizona and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Derrik James Dotter Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
MESA, AZ 85210
MESA, AZ 85210
MESA, AZ 85210
MESA, AZ 85210
MESA, AZ 85210
MESA, AZ 85210
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 Derrik Dotter's NPI number?
The NPI number for Derrik Dotter is 1659168508. It was assigned to this individual provider in the NPPES registry on April 23, 2025.
Where is Derrik Dotter located?
Derrik Dotter practices at 1300 S Country Club Dr Ste 3, Mesa, AZ 85210. The listed phone number is (480) 827-5500.
What is Derrik Dotter's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Derrik Dotter enrolled in Medicare?
Yes. Derrik Dotter is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Derrik Dotter was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.
# Derrik James Dotter, DO · NPI 1659168508
Student in an Organized Health Care Education/Training Program provider in Mesa, Arizona. Individual provider, active in the CMS NPPES registry since April 23, 2025.
## Identity
- **NPI:** 1659168508 (Entity type: Individual)
- **Enumerated:** April 23, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1300 S COUNTRY CLUB DR STE 3, Mesa, AZ 85210-5162
- **Phone:** (480) 827-5500
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1659168508) · Data from the CMS NPPES public registry.