DR. DEREK BRADLEY DOUGLAS D.O.
NPI 1902307762
Emergency Medicine in Fort Leonard Wood, MO
About Dr. Derek Bradley Douglas D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DEREK BRADLEY DOUGLAS D.O. (NPI 1902307762) is an individual emergency medicine provider in Fort Leonard Wood, Missouri, licensed in Missouri (2021020693) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Derek Bradley Douglas D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
6Medicare enrollment records show Derek Douglas reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
St. Robert, MO 65584
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1245277631 (Missouri)
- 1,487 clinicians in this Medicare group
Houston, MO 65483
- Reassigned Medicare billing, Missouri enrollment
- 338 clinicians in this Medicare group
Houston, MO 65483
- Reassigned Medicare billing, Missouri enrollment
- 101 clinicians in this Medicare group
Springfield, MO 65804
- Reassigned Medicare billing, Missouri enrollment
- 169 clinicians in this Medicare group
Carthage, MO 64836
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1003201955 (Missouri)
- 133 clinicians in this Medicare group
Carthage, MO 64836
- Reassigned Medicare billing, Missouri enrollment
- 562 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 65473 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.
FORT LEONARD WOOD, MO 65473
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 Derek Douglas's NPI number?
The NPI number for Derek Douglas is 1902307762. It was assigned to this individual provider in the NPPES registry on February 26, 2018.
Where is Derek Douglas located?
Derek Douglas practices at 4234 Illinois Ave, Fort Leonard Wood, MO 65473. The listed phone number is (573) 596-0035.
What is Derek Douglas's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Derek Douglas enrolled in Medicare?
Yes. Derek Douglas is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Derek Douglas's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Derek Douglas reassigns Medicare benefits to 6 organizations: Mercy Clinic Springfield Communities (St. Robert, MO), Ozarks Medical Center (Houston, MO), Texas County Memorial Hospital (Houston, MO), Mercy Hospital Springfield (Springfield, MO), Mercy Hospital Carthage (Carthage, MO) and 1 more organization, 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 Derek Douglas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Derek Douglas accept?
Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Derek Douglas 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 Derek Douglas was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dr. Derek Bradley Douglas, D.O. · NPI 1902307762
Emergency Medicine physician in Fort Leonard Wood, Missouri. Individual provider, active in the CMS NPPES registry since February 26, 2018.
## Identity
- **NPI:** 1902307762 (Entity type: Individual)
- **Enumerated:** February 26, 2018
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 2021020693 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 4234 ILLINOIS AVE, Fort Leonard Wood, MO 65473-9098
- **Phone:** (573) 596-0035
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Mercy Clinic Springfield Communities (NPI 1770616781, St. Robert, MO); Ozarks Medical Center (NPI 1770424541, Houston, MO); Texas County Memorial Hospital (NPI 1790740363, Houston, MO); Mercy Hospital Springfield (NPI 1043242159, Springfield, MO); Mercy Hospital Carthage (NPI 1558628222, Carthage, MO); and 1 more · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 14, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1902307762) · Data from the CMS NPPES public registry.