DEREK S VERSALLE DO
NPI 1669162616
Emergency Medicine in Portage, MI
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 and is a graduate of Michigan State University College Of Osteopathic Medicine (2023).
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 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.
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.
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.
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.
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 14 days 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.
# Derek S Versalle, DO · NPI 1669162616
Emergency Medicine physician in Portage, Michigan. Individual provider, active in the CMS NPPES registry since May 12, 2023.
## Identity
- **NPI:** 1669162616 (Entity type: Individual)
- **Enumerated:** May 12, 2023
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 5151016178 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 950 TRADE CENTRE WAY, Portage, MI 49002-0487
- **Phone:** (269) 370-1824
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Michigan State University College Of Osteopathic Medicine, class of 2023
## Record status
- **NPPES last updated:** July 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1669162616) · Data from the CMS NPPES public registry.