DERIK K KENWORTHY DO
NPI 1861726077
Radiology - Diagnostic Radiology in Edina, MN

Active since September 22, 2009PECOS EnrolledAccepts Medicare Assignment
3600 MINNESOTA DR STE 800, EDINA, MN 55435(952) 595-1100(612) 294-4903 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 5, 2026, Mar 9, 2026, Sep 6, 2024 (3 updates tracked since 2024).

About Derik K Kenworthy Do NPPES

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

DERIK K KENWORTHY DO (NPI 1861726077) is an individual diagnostic radiology provider in Edina, Minnesota, licensed in Oregon (DO220167) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS, is affiliated with Ed Fraser Memorial Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1861726077
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDERIK K KENWORTHYCredential: DO
Location Address3600 MINNESOTA DR STE 800Edina, MN 55435-7915
Mailing Address3600 Minnesota Dr Ste 800Edina, MN 55435-7915 · (952) 595-1100 · Fax (612) 294-4903
Fax(612) 294-4903
Sole ProprietorNo
Medical School CMSAt Still Un Of Hlth Sciences, Col Of Osteo Med, MesaGraduated 2019
Enumeration DateSeptember 22, 2009
Last NPPES UpdateJune 23, 20263 updates tracked since enumeration
NPPES CertifiedJune 23, 2026
NPI 1861726077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses Licensed in OR · DO220167 Licensed in KS · 05-50096 Licensed in FL · OS21657 Licensed in MT · MED-PHYS-LIC-148473 Licensed in TX · V3891 Licensed in OK · 8833 Licensed in CO · DR.0074105 Licensed in UT · 14225604-1204
Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

3600 MINNESOTA DR STE 800, Edina, MN 55435

Secondary Practice Locations 4

Location 11501 E 3rd StDelta, CO 81416-2815 · Phone (970) 874-7681
Location 21110 N Sarah DeWitt DrGonzales, TX 78629-3311 · Phone (816) 800-9020
Location 31460 G StSpringfield, OR 97477-4112 · Phone (816) 800-9020
Location 41979 W Ray RdChandler, AZ 85224-4007 · Phone (480) 821-9404 · Fax (480) 857-1490

Other Identifiers 3

Medicaid503865AZ
Medicaid9000254965CO
OtherZ173125Medicare Ptan

Accepted 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

Derik K Kenworthy Do 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 ID5193852077
PECOS Enrollment IDI20240920003617, I20241104001444, I20250113001239, I20250321003245, I20250717000989, I20251107000213, I20260423002484
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 5

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

Ed Fraser Memorial Hospital

Acute Care Hospitals · Macclenny, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100134
Location159 N 3rd StMacclenny, FL 32063 · Baker County
Emergency services

Bay Area Hospital

Acute Care Hospitals · Coos Bay, OR
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number380090
Location1775 Thompson RoadCoos Bay, OR 97420 · Coos County
Emergency services

Memorial Hospital

Acute Care Hospitals · Gonzales, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450235
Location1110 North Sarah Dewitt DriveGonzales, TX 78629 · Gonzales County
Birthing friendly

Yoakum Community Hospital

Critical Access Hospitals · Yoakum, TX
OwnershipVoluntary non-profit - Private
CMS Certification Number451346
Location1200 Carl Ramert DriveYoakum, TX 77995 · Lavaca County
Emergency services

Kane County Hospital

Critical Access Hospitals · Kanab, UT
OwnershipGovernment - Hospital District or Authority
CMS Certification Number461309
Location355 North Main StreetKanab, UT 84741 · Kane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55435 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

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.

Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435

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 Derik Kenworthy's NPI number?

The NPI number for Derik Kenworthy is 1861726077. It was assigned to this individual provider in the NPPES registry on September 22, 2009.

Where is Derik Kenworthy located?

Derik Kenworthy practices at 3600 Minnesota Dr Ste 800, Edina, MN 55435. The listed phone number is (952) 595-1100.

What is Derik Kenworthy's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Derik Kenworthy enrolled in Medicare?

Yes. Derik Kenworthy 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 Derik Kenworthy accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Kansas, Inc., Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Texas and Molina Healthcare and 2 other insurers list Derik Kenworthy 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.

Is Derik Kenworthy affiliated with any hospitals?

According to CMS data, Derik Kenworthy is affiliated with Ed Fraser Memorial Hospital, Bay Area Hospital, Memorial Hospital, Yoakum Community Hospital and Kane County Hospital.

When was this NPI record last updated?

The NPPES record for Derik Kenworthy was last updated on June 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.