1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

GWENDOLYN ROSE DERK
NPI 1811639404
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since April 13, 2022PECOS EnrolledAccepts Medicare Assignment
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 681-1700 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gwendolyn Rose Derk NPPES

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

GWENDOLYN ROSE DERK (NPI 1811639404) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, is affiliated with Hillsboro Medical Center, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2022).

NPPES Registry Identity

NPI1811639404
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameGWENDOLYN ROSE DERK
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3098
Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3098 · (503) 681-1700
Phone(503) 681-1700
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2022
Enumeration DateApril 13, 2022
NPPES CertifiedApril 13, 2022
✔ NPI 1811639404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
Open in Google Maps ↗

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

Gwendolyn Rose Derk 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 ID2567848385
PECOS Enrollment IDI20250630002841
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.

Hospital Affiliations CMS Care Compare

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

Hillsboro Medical Center

Acute Care Hospitals · Hillsboro, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380021
Location335 SE 8th AvenueHillsboro, OR 97123 · Washington County
Emergency services Birthing friendly

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.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 Gwendolyn Derk's NPI number?

The NPI number for Gwendolyn Derk is 1811639404. It was assigned to this individual provider in the NPPES registry on April 13, 2022.

Where is Gwendolyn Derk located?

Gwendolyn Derk practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 681-1700.

What is Gwendolyn Derk's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Gwendolyn Derk enrolled in Medicare?

Yes. Gwendolyn Derk 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.

Is Gwendolyn Derk affiliated with any hospitals?

According to CMS data, Gwendolyn Derk is affiliated with Hillsboro Medical Center.

When was this NPI record last updated?

The NPPES record for Gwendolyn Derk was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.