DERIK K KENWORTHY DO
NPI 1861726077
Radiology - Diagnostic Radiology in Edina, MN
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
Specialties & Licenses
Secondary Practice Locations 4
Other Identifiers 3
Accepted 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
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.
Medicare Billing Reassignments
22Medicare enrollment records show Derik Kenworthy reassigns Medicare billing to 22 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Edina, MN 55435
- Reassigned Medicare billing, Utah enrollment
- 9 clinicians in this Medicare group
Dodge City, KS 67801
- Reassigned Medicare billing, Kansas enrollment
- 37 clinicians in this Medicare group
Brentwood, TN 37027
- Reassigned Medicare billing, Oregon enrollment
- 198 clinicians in this Medicare group
Lewistown, MT 59457
- Reassigned Medicare billing, Montana enrollment
- 173 clinicians in this Medicare group
Dimmitt, TX 79027
- Reassigned Medicare billing, Texas enrollment
- Also billed through NPI 1891828059 (Texas)
- 43 clinicians in this Medicare group
Rotan, TX 79546
- Reassigned Medicare billing, Texas enrollment
- Also billed through NPI 1104808112 (Texas)
- 61 clinicians in this Medicare group
Sheridan, MT 59749
- Reassigned Medicare billing, Montana enrollment
- 41 clinicians in this Medicare group
Hemphill, TX 75948
- Reassigned Medicare billing, Texas enrollment
- 26 clinicians in this Medicare group
Lamesa, TX 79331
- Reassigned Medicare billing, Texas enrollment
- 28 clinicians in this Medicare group
Coleman, TX 76834
- Reassigned Medicare billing, Texas enrollment
- 27 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, FLMckenzie-Willamette Medical Center
Acute Care Hospitals · Springfield, ORBay Area Hospital
Acute Care Hospitals · Coos Bay, ORMemorial Hospital
Acute Care Hospitals · Gonzales, TXYoakum Community Hospital
Critical Access Hospitals · Yoakum, TXPhysician 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.
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.
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.
Which organizations bill Medicare for Derik Kenworthy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Derik Kenworthy reassigns Medicare benefits to 22 organizations: Virtual Radiologic Professionals, LLC (Edina, MN), Minneola District Hospital Nbr 2 (Dodge City, KS), Mckenzie Physician Services LLC (Brentwood, TN), Central Montana Medical Facilities, Inc. (Lewistown, MT), Castro County Hospital District (Dimmitt, TX) and 17 more organizations, listed in the Medicare section above. Each 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 Derik Kenworthy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Derik Kenworthy accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 13 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, Mckenzie-Willamette Medical Center, Bay Area Hospital, Memorial Hospital and Yoakum Community Hospital.
When was this NPI record last updated?
The NPPES record for Derik Kenworthy was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Derik K Kenworthy, DO · NPI 1861726077
Diagnostic Radiology physician in Edina, Minnesota. Individual provider, active in the CMS NPPES registry since September 22, 2009.
## Identity
- **NPI:** 1861726077 (Entity type: Individual)
- **Enumerated:** September 22, 2009
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** DO220167 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3600 MINNESOTA DR STE 800, Edina, MN 55435-7915
- **Phone:** (952) 595-1100 · **Fax:** (612) 294-4903
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 22 organizations under Medicare reassignment (form CMS-855R): Virtual Radiologic Professionals, LLC (NPI 1932342029, Edina, MN); Minneola District Hospital Nbr 2 (NPI 1447986757, Dodge City, KS); Mckenzie Physician Services LLC (NPI 1316909054, Brentwood, TN); Central Montana Medical Facilities, Inc. (NPI 1770696601, Lewistown, MT); Castro County Hospital District (NPI 1033118716, Dimmitt, TX); and 17 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** At Still Un Of Hlth Sciences, Col Of Osteo Med, Mesa, class of 2019
## Record status
- **NPPES last updated:** June 23, 2026
- **Other identifiers:** Medicaid 503865 (AZ); Medicaid 9000254965 (CO); Other Z173125
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Source: [NPI Profile](https://npiprofile.com/npi/1861726077) · Data from the CMS NPPES public registry.