DR. JAMES A DERBY MD
NPI 1760463525
Hospitalist in Niceville, FL

Q: What is James Derby's NPI number?

The NPI number for James Derby is 1760463525. It was assigned to this individual provider in the NPPES registry on November 9, 2005.

Q: What is James Derby's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for James Derby was last updated on May 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since November 09, 2005PECOS EnrolledAccepts Medicare Assignment

2190 HIGHWAY 85 N, NICEVILLE, FL 32578(850) 678-4181(850) 729-9418 Get Directions Write a Review

NPPES record last updated: May 9, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. James A Derby Md NPPES

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

DR. JAMES A DERBY MD (NPI 1760463525) is an individual hospitalist provider in Niceville, Florida, licensed in Florida (ME80573) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Twin Cities Hospital, and is a graduate of University Of Missouri, Columbia School Of Medicine (1982).

NPPES Registry Identity

NPI1760463525

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. JAMES A DERBYCredential: MD

Location Address2190 HIGHWAY 85 NNiceville, FL 32578-1045

Mailing Address457 Ruckel DrNiceville, FL 32578-1782 · (850) 496-3096

Phone(850) 678-4181

Fax(850) 729-9418

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1982

Enumeration DateNovember 9, 2005

Last NPPES UpdateMay 9, 2023

NPPES CertifiedMay 9, 2023

✔ NPI 1760463525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in FL · ME80573

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedEmergency MedicineTaxonomy 207P00000X · License ME80573 (FL)

Also ListedFamily MedicineTaxonomy 207Q00000X · License ME80573 (FL)

2190 HIGHWAY 85 N, Niceville, FL 32578

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Other Identifiers 5

Other059185372AL · Bcbs Al

Other059185483AL · Bcbs Al

Other51635FL · Bc/bs Fl

Other97861FL · Bcbs Fl

Medicaid259858200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida.Insurance ›

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

Dr. James A Derby Md 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 ID143127217

PECOS Enrollment IDI20031217000094

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 James Derby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hospital Medicine Services Of Fl, LLC

499 mi

Hospitalist

20900 BISCAYNE BLVD
Aventura, FL 33180

Reassigned Medicare billing, Florida enrollment
861 clinicians in this Medicare group

NPI 1710684857 (305) 682-7000

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

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

525 services218 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

278 services139 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

246 services229 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

203 services188 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

185 services77 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

65 services63 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Twin Cities Hospital

Acute Care Hospitals · Niceville, FL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number100054

Location2190 Hwy 85 NNiceville, FL 32578 · Okaloosa County

Emergency services

Hca Florida Fort Walton-Destin Hospital

Acute Care Hospitals · Fort Walton Beach, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100223

Location1000 Mar-Walt DrFort Walton Beach, FL 32547 · Okaloosa County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32578 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%478 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers47 claims47 services$17.13 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers56 claims56 services$86.08 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$31.69 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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