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DR. DEREK J. CLARKE M.D.
NPI 1982612354
Obstetrics & Gynecology in Cynthiana, KY

Active since August 03, 2006PECOS EnrolledAccepts Medicare Assignment
83.31/100
CMS Quality Rating
1210 KY HIGHWAY 36 E, SUITE G4, CYNTHIANA, KY 41031(859) 234-9955(859) 234-9959 Get Directions Write a Review

NPPES record last updated: March 24, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Derek J. Clarke M.d. NPPES

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

DR. DEREK J. CLARKE M.D. (NPI 1982612354) is an individual obstetrics & gynecology provider in Cynthiana, Kentucky, licensed in Kentucky (33944) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Harrison Memorial Hospital, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1982612354
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. DEREK J. CLARKECredential: M.D.
Location Address1210 KY HIGHWAY 36 E, SUITE G4Cynthiana, KY 41031-7490
Mailing Address1210 Ky Highway 36 E, Suite G4Cynthiana, KY 41031-7490 · (859) 234-9955 · Fax (859) 234-9965
Phone(859) 234-9955
Fax(859) 234-9959
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateAugust 3, 2006
Last NPPES UpdateMarch 24, 2014
✔ NPI 1982612354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in KY · 33944
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedNurse Practitioner · Obstetrics & GynecologyTaxonomy 363LX0001X · License 78903804 (KY)
1210 KY HIGHWAY 36 E, Cynthiana, KY 41031
Open in Google Maps ↗

Other Identifiers 5

Medicare ID-Type Unspecified0727001
Medicaid64339443KY
Other1265588990KY · Npi Women's Health Clinic
Other1982612354KY · Npi Dr. Derek J Clarke
Medicare UPING82144

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.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

Dr. Derek J. Clarke M.d. 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 ID3173562949
PECOS Enrollment IDI20101014001205
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Derek Clarke reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Harrison Memorial Hospital Inc
Same address
Multi-Specialty
1210 KY HIGHWAY 36 E
Cynthiana, KY 41031
  • Reassigned Medicare billing, Kentucky enrollment
  • 81 clinicians in this Medicare group
NPI 1669615233 (859) 234-2300
Harrison Memorial Hospital
2.6 mi
Clinic/Center
1210 KY HIGHWAY 36 E
Cynthiana, KY 41031
  • Reassigned Medicare billing, Kentucky enrollment
  • 54 clinicians in this Medicare group
NPI 1386783868 (859) 234-2300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.
25 services20 patients

Hospital Affiliations CMS Care Compare 2

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

Harrison Memorial Hospital

Acute Care Hospitals · Cynthiana, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180079
Location1210 Ky Hwy 36 ECynthiana, KY 41031 · Harrison County
Emergency services Birthing friendly

Riverside Shore Memorial Hospital

Acute Care Hospitals · Onancock, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490037
Location20480 Market StreetOnancock, VA 23417 · Accomack County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41031 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85
Promoting Interoperability100
Improvement Activities40
Cost52.71

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.

MR. LARRY M WILEY R.PH.
Pharmacist
1210 KY HIGHWAY 36 E, SUITE G-6
CYNTHIANA, KY 41031
Harrison County (859) 234-2777
JEFF A TAYLOR CRNA
Nurse Anesthetist, Certified Registered
1210 KY HIGHWAY 36 E
CYNTHIANA, KY 41031
Harrison County (859) 235-3500
HARRISON MEMORIAL HOSPITAL
Family Medicine
1210 KY HIGHWAY 36 E, SUITE 1A
CYNTHIANA, KY 41031
Harrison County (859) 234-5555
C. KARL SCHULSTAD, M.D., PSC
Surgery
1210 KY HIGHWAY 36 E, SUITE 2B
CYNTHIANA, KY 41031
Harrison County (859) 234-0390
DOUGLAS C CRUTCHER MD
Radiology (Diagnostic Radiology)
1210 KY HIGHWAY 36 E
CYNTHIANA, KY 41031
Harrison County (859) 234-2300
DR. SOFIE LAVINIA PINNEY DPM
Podiatrist (Foot & Ankle Surgery)
1210 KY HIGHWAY 36 E
CYNTHIANA, KY 41031
Harrison County (859) 235-3562
MRS. LEIGH ANN KING FNP-C
Nurse Practitioner
1210 KY HIGHWAY 36 E
CYNTHIANA, KY 41031
Harrison County (859) 234-2300
GERALD R. HARPEL M.D.
Obstetrics & Gynecology
1210 KY HIGHWAY 36 E, SUITE 1A
CYNTHIANA, KY 41031
Harrison County (859) 234-5555

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 Clarke's NPI number?

The NPI number for Derek Clarke is 1982612354. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Derek Clarke located?

Derek Clarke practices at 1210 Ky Highway 36 E Suite G4, Cynthiana, KY 41031. The listed phone number is (859) 234-9955.

What is Derek Clarke's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Derek Clarke enrolled in Medicare?

Yes. Derek Clarke 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 Derek Clarke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Clarke reassigns Medicare benefits to 2 organizations: Harrison Memorial Hospital Inc (Cynthiana, KY) and Harrison Memorial Hospital (Cynthiana, KY). 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 Clarke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derek Clarke accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Derek Clarke 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 Derek Clarke affiliated with any hospitals?

According to CMS data, Derek Clarke is affiliated with Harrison Memorial Hospital and Riverside Shore Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Derek Clarke was last updated on March 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.