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DEREK S VERSALLE DO
NPI 1669162616
Emergency Medicine in Portage, MI

Active since May 12, 2023PECOS EnrolledAccepts Medicare Assignment
950 TRADE CENTRE WAY, PORTAGE, MI 49002(269) 370-1824 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 29, 2026, May 23, 2023, May 12, 2023 (3 updates tracked since 2023).

About Derek S Versalle Do NPPES

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

DEREK S VERSALLE DO (NPI 1669162616) is an individual emergency medicine provider in Portage, Michigan, licensed in Michigan (5151016178) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and is a graduate of Michigan State University College Of Osteopathic Medicine (2023).

NPPES Registry Identity

NPI1669162616
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDEREK S VERSALLECredential: DO
Location Address950 TRADE CENTRE WAYPortage, MI 49002-0487
Mailing Address950 Trade Centre Way Ste 230Portage, MI 49002-0492
Phone(269) 370-1824
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2023
Enumeration DateMay 12, 2023
Last NPPES UpdateJuly 29, 20263 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1669162616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MI · 5151016178
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
950 TRADE CENTRE WAY, Portage, MI 49002
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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

Derek S Versalle Do 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 ID3678939279
PECOS Enrollment IDI20260203001476
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 Derek Versalle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southwestern Michigan Emergency Services, PC
3.7 mi
Emergency Medical Services
125 S KALAMAZOO MALL, SUITE 204
Kalamazoo, MI 49007
  • Reassigned Medicare billing, Michigan enrollment
  • 85 clinicians in this Medicare group
NPI 1013021310 (866) 898-7139

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

Hospital Affiliations CMS Care Compare 2

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

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230017
Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County
Emergency services Birthing friendly

Bronson Battle Creek Hospital

Acute Care Hospitals · Battle Creek, MI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number230075
Location300 North AvenueBattle Creek, MI 49017 · Calhoun County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49002 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

DR. ROBERT S YEUNG DDS, MS
Dentist
950 TRADE CENTRE WAY, SUITE 225
PORTAGE, MI 49002
Kalamazoo County (269) 349-2189
GREAT LAKES ENDODONTICS
Dentist (Endodontics)
950 TRADE CENTRE WAY, STE 225
PORTAGE, MI 49002
Kalamazoo County (269) 349-2189

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 Versalle's NPI number?

The NPI number for Derek Versalle is 1669162616. It was assigned to this individual provider in the NPPES registry on May 12, 2023.

Where is Derek Versalle located?

Derek Versalle practices at 950 Trade Centre Way, Portage, MI 49002. The listed phone number is (269) 370-1824.

What is Derek Versalle's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Derek Versalle enrolled in Medicare?

Yes. Derek Versalle 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 Derek Versalle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Versalle reassigns Medicare benefits to Southwestern Michigan Emergency Services, PC (Kalamazoo, MI). 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 Versalle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Derek Versalle affiliated with any hospitals?

According to CMS data, Derek Versalle is affiliated with Bronson Methodist Hospital and Bronson Battle Creek Hospital.

When was this NPI record last updated?

The NPPES record for Derek Versalle was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.