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MICHAEL DERRICK M.D.
NPI 1790133734
Pediatrics in Richmond, IN

Active since June 01, 2016PECOS Enrolled
1100 REID PKWY, REID HOSPITAL & HEALTH CARE SERVICES, RICHMOND, IN 47374(765) 983-3492(765) 983-7958 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 13, 2021, Nov 4, 2020, Jul 16, 2019 (3 updates tracked since 2019).

About Michael Derrick M.d. NPPES

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

MICHAEL DERRICK M.D. (NPI 1790133734) is an individual pediatrics provider in Richmond, Indiana, licensed in Indiana (01082585A) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Gainesville.

NPPES Registry Identity

NPI1790133734
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMICHAEL DERRICKCredential: M.D.
Location Address1100 REID PKWY, REID HOSPITAL & HEALTH CARE SERVICESRichmond, IN 47374
Mailing Address1100 Reid Pkwy, Medical Staff ServicesRichmond, IN 47374-1157 · (765) 935-8807 · Fax (765) 935-8807
Phone(765) 983-3492
Fax(765) 983-7958
Sole ProprietorNo
Enumeration DateJune 1, 2016
Last NPPES UpdateMay 13, 20213 updates tracked since enumeration
NPPES CertifiedMay 13, 2021
✔ NPI 1790133734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IN · 01082585A
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1100 REID PKWY, Richmond, IN 47374
Open in Google Maps ↗

Secondary Practice Location 1

Location 11600 SW Archer Rd, HD408Gainesville, FL 32610-3003 · Phone (801) 362-1718

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, BridgeSpan Health Company 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)

Michael Derrick M.d. 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 Reassignment

Medicare enrollment records show Michael Derrick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tanner Memorial Clinic
1,421 mi
Primary Care
444 W BOURNE CIR
Farmington, UT 84025
  • Reassigned Medicare billing, Utah enrollment
  • 270 clinicians in this Medicare group
NPI 1447845730 (801) 773-4840

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47374 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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 20

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

JUSTIN VARGHESE
Internal Medicine
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
MALLORY J CROSS PA-C
Physician Assistant
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
DR. JOHN E MCGINTY IV M.D.
Internal Medicine (Cardiovascular Disease)
1100 REID PKWY, SUITE 210
RICHMOND, IN 47374
Wayne County (765) 962-1337
THOMAS P. GLYNN JR. M.D.
Radiology (Diagnostic Radiology)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
SADIA KHAN MD
Student in an Organized Health Care Education/Training Program
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3822
DR. TYLER BROOKS FREDENBURG MD
Radiology (Diagnostic Radiology)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3164
AHMAD S KHATRI MD
Family Medicine
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3492
SHARON SMITH LAT, ATC
Specialist/Technologist (Athletic Trainer)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000

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 Michael Derrick's NPI number?

The NPI number for Michael Derrick is 1790133734. It was assigned to this individual provider in the NPPES registry on June 1, 2016.

Where is Michael Derrick located?

Michael Derrick practices at 1100 Reid Pkwy Reid Hospital & Health Care Services, Richmond, IN 47374. The listed phone number is (765) 983-3492.

What is Michael Derrick's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Michael Derrick enrolled in Medicare?

Yes. Michael Derrick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Michael Derrick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Derrick reassigns Medicare benefits to Tanner Memorial Clinic (Farmington, UT). 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 Michael Derrick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Derrick accept?

Health plans from Ambetter Health, Ambetter from Sunflower Health Plan, BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health and 1 other insurer list Michael Derrick 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 Michael Derrick was last updated on May 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.