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DERIC H NYE D.O.
NPI 1699014464
Orthopaedic Surgery - Pediatric Orthopaedic Surgery in Glendale, AZ

Active since February 13, 2013PECOS Enrolled
5601 W EUGIE AVE STE 100, GLENDALE, AZ 85304(602) 865-4510(602) 865-6100 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 24, 2025, Apr 13, 2020, Jul 11, 2019 (3 updates tracked since 2019).

About Deric H Nye D.o. NPPES

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

DERIC H NYE D.O. (NPI 1699014464) is an individual pediatric orthopaedic surgery provider in Glendale, Arizona, licensed in Arizona (009320) and active in the NPI registry since February 2013. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1699014464
Entity TypeIndividualMale
Primary Taxonomy207XP3100X
Provider Legal NameDERIC H NYECredential: D.O.
Location Address5601 W EUGIE AVE STE 100Glendale, AZ 85304-1256
Mailing Address5601 W Eugie Ave Ste 100Glendale, AZ 85304-1256 · (602) 865-4510 · Fax (602) 865-6100
Phone(602) 865-4510
Fax(602) 865-6100
Sole ProprietorNo
Enumeration DateFebruary 13, 2013
Last NPPES UpdateJune 24, 20253 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
✔ NPI 1699014464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Pediatric Orthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XP3100X
Licenses✔ Licensed in AZ · 009320✔ Licensed in CA · 20A17398
Definition
An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.
5601 W EUGIE AVE STE 100, Glendale, AZ 85304
Open in Google Maps ↗

Secondary Practice Locations 3

Location 19300 Valley Childrens PlMadera, CA 93636-8762 · Phone (559) 353-5941 · Fax (559) 353-5945
Location 29300 Valley Childrens Pl # Fe10Madera, CA 93636-8761 · Phone (559) 353-5941
Location 32213 Cherry StToledo, OH 43608-2603 · Phone (419) 251-6596 · Fax (419) 251-6849

Other Identifiers 1

Medicaid1699014464CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deric H Nye D.o. 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

2

Medicare enrollment records show Deric Nye reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Banner Physician Super Specialists Arizona LLC
0.5 mi
Nutrition, Education
5310 W THUNDERBIRD RD STE 214
Glendale, AZ 85306
  • Reassigned Medicare billing, Arizona enrollment
  • 188 clinicians in this Medicare group
NPI 1578125738 (602) 865-4480
Valley Children's Medical Group
569 mi
Pediatrics
1524 MCHENRY AVE, SUITE 550
Modesto, CA 95350
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Valley Childrens Medical Group
  • 387 clinicians in this Medicare group
NPI 1437555265 (559) 353-5010

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

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DENISE LYN LOPEZ PA-C
Physician Assistant
5601 W EUGIE AVE STE 100
GLENDALE, AZ 85304
Maricopa County (602) 865-4510
DYLAN JAMES KERTZIE
Physician Assistant
5601 W EUGIE AVE STE 100
GLENDALE, AZ 85304
Maricopa County (602) 298-8888
SHASTA ELIZABETH HENDERSON MD
Orthopaedic Surgery (Orthopaedic Trauma)
5601 W EUGIE AVE STE 100
GLENDALE, AZ 85304
Maricopa County (602) 865-4510
BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
Durable Medical Equipment & Medical Supplies
5601 W EUGIE AVE STE 100
GLENDALE, AZ 85304
Maricopa County (602) 865-4510
DESERT WEST OBGYN
Obstetrics & Gynecology
5601 W EUGIE AVE STE 100
GLENDALE, AZ 85304
Maricopa County (602) 978-1500
BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
Durable Medical Equipment & Medical Supplies
5601 W EUGIE AVE STE 100
GLENDALE, AZ 85304
Maricopa County (602) 747-4000

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 Deric Nye's NPI number?

The NPI number for Deric Nye is 1699014464. It was assigned to this individual provider in the NPPES registry on February 13, 2013.

Where is Deric Nye located?

Deric Nye practices at 5601 W Eugie Ave Ste 100, Glendale, AZ 85304. The listed phone number is (602) 865-4510.

What is Deric Nye's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Pediatric Orthopaedic Surgery, with taxonomy code 207XP3100X.

Is Deric Nye enrolled in Medicare?

Yes. Deric Nye is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Deric Nye's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deric Nye reassigns Medicare benefits to 2 organizations: Banner Physician Super Specialists Arizona LLC (Glendale, AZ) and Valley Children's Medical Group (Modesto, CA). 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 Deric Nye's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Deric Nye accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. and 1 other insurer list Deric Nye 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 Deric Nye was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.