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DEREK WISE MA, LCPC
NPI 1740692334
Counselor - Professional in Las Vegas, NV

Active since May 30, 2014PECOS Enrolled
5510 S FORT APACHE RD, LAS VEGAS, NV 89148(702) 604-2498 Get Directions Write a Review

NPPES record last updated: May 31, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 31, 2025, Jul 21, 2019, Feb 4, 2016 (3 updates tracked since 2016).

About Derek Wise Ma, Lcpc NPPES

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

DEREK WISE MA, LCPC (NPI 1740692334) is an individual professional provider in Las Vegas, Nevada, licensed in Nevada (CP1204) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1740692334
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDEREK WISECredential: MA, LCPC
Location Address5510 S FORT APACHE RDLas Vegas, NV 89148-7700
Mailing Address5510 S Fort Apache RdLas Vegas, NV 89148-7700 · (702) 604-2498
Phone(702) 604-2498
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateMay 30, 2014
Last NPPES UpdateMay 31, 20253 updates tracked since enumeration
NPPES CertifiedMay 21, 2025
✔ NPI 1740692334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in NV · CP1204
5510 S FORT APACHE RD, Las Vegas, NV 89148
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Wise Ma, Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476082116
PECOS Enrollment IDI20250925004002
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 Wise reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health Specialty Group PA
2,026 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Nevada enrollment
  • 77 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

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 10

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

NOVA HEALTH ASSOCIATES, LLC
Family Medicine
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (702) 268-8900
FREE YOUR MIND PSYCHIATRIC LLC
Psychiatry & Neurology (Psychiatry)
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (725) 215-6340
KAYCI COOLEY LCSW
Social Worker (Clinical)
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (702) 582-6553
ANGELA JIMENEZ SANCHEZ APRN
Nurse Practitioner (Pediatrics)
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (725) 867-8144
MERIDIAN COUNSELING SERVICES, LLC
Nurse Practitioner (Psychiatric/Mental Health)
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (702) 604-2498
MS. MARY FRIENDSHIP
Counselor (Mental Health)
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (702) 686-4777
PERSIA THE PSYCH NP LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (702) 848-5520
JESSICA POTUCEK APRN, FNP-BC
Nurse Practitioner (Family)
5510 S FORT APACHE RD
LAS VEGAS, NV 89148
Clark County (702) 899-0100

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 Wise's NPI number?

The NPI number for Derek Wise is 1740692334. It was assigned to this individual provider in the NPPES registry on May 30, 2014.

Where is Derek Wise located?

Derek Wise practices at 5510 S Fort Apache Rd, Las Vegas, NV 89148. The listed phone number is (702) 604-2498.

What is Derek Wise's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Derek Wise enrolled in Medicare?

Yes. Derek Wise is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Derek Wise's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Wise reassigns Medicare benefits to Mental Health Specialty Group PA (Durham, NC). 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 Wise's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derek Wise accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health and Molina Healthcare list Derek Wise 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 Derek Wise was last updated on May 31, 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.