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JEREMY DERICKSON PA-C
NPI 1821544503
Physician Assistant in Mesa, AZ

Active since August 31, 2016PECOS EnrolledAccepts Medicare Assignment
3720 E PUEBLO AVE, MESA, AZ 85206(928) 200-3526 Get Directions Write a Review

NPPES record last updated: October 21, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Oct 21, 2016, Aug 31, 2016 (2 updates tracked since 2016).

About Jeremy Derickson Pa-c NPPES

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

JEREMY DERICKSON PA-C (NPI 1821544503) is an individual physician assistant in Mesa, Arizona and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS and is a graduate of At Still University, Arizona School Of Dentistry & Oral Hlth (2016).

NPPES Registry Identity

NPI1821544503
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJEREMY DERICKSONCredential: PA-C
Location Address3720 E PUEBLO AVEMesa, AZ 85206-1821
Mailing Address2310 E Brown RdMesa, AZ 85213-5226 · (480) 649-9000 · Fax (480) 248-9206
Phone(928) 200-3526
Sole ProprietorNo
Medical School CMSAt Still University, Arizona School Of Dentistry & Oral HlthGraduated 2016
Enumeration DateAugust 31, 2016
Last NPPES UpdateOctober 21, 20162 updates tracked since enumeration
✔ NPI 1821544503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3720 E PUEBLO AVE, Mesa, AZ 85206
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, UnitedHealthcare.Insurance ›

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

Jeremy Derickson Pa-c 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 ID6406134014
PECOS Enrollment IDI20161102002479
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.

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
339 services172 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
156 services127 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
111 services111 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
39 services38 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
22 services21 patients
Removal of impacted ear wax by washing 69209
Impacted ear wax removal by washing, also known as ear irrigation, involves using a pressurized flow of water to break up and dislodge the ear wax. This safe procedure helps restore normal hearing and relieve discomfort caused by the blockage.
19 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85206 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers16 claims33 services$4.59 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Jeremy Derickson's NPI number?

The NPI number for Jeremy Derickson is 1821544503. It was assigned to this individual provider in the NPPES registry on August 31, 2016.

Where is Jeremy Derickson located?

Jeremy Derickson practices at 3720 E Pueblo Ave, Mesa, AZ 85206. The listed phone number is (928) 200-3526.

What is Jeremy Derickson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jeremy Derickson enrolled in Medicare?

Yes. Jeremy Derickson 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.

What insurance does Jeremy Derickson accept?

Health plans from Blue Cross Blue Shield of Arizona and UnitedHealthcare list Jeremy Derickson 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 Jeremy Derickson was last updated on October 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.