DERRICK D KOOKER (P.A.) – Surgical Physician Assistant, NPI 1851373526
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,161 PHYSICIAN ASSISTANT in CO
Provider Addresses for DERRICK D KOOKER (P.A.)
Penrose Hospital, 2222, North Nevada Avenue, Colorado Springs, El Paso County, Colorado, 80907, United States
SUITE
COLORADO SPRINGS, CO 809076819
Phone: (719) 776-7600
Type: Mailing
2312 N NEVADA AVE STE 235
COLORADO SPRINGS, CO 809075312
Phone: (719) 776-7600
Fax: (719) 473-3553
Type: Location
2222 N Nevada Ave
Suite
Colorado Springs, CO 809076819
Phone: (719) 776-7600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 27 Open Payments records for all available years, with a total value of $1,407.
Total Amount is formed as General ($1,407) + Research ($0) + Ownership ($0) = $1,407.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Baxter Healthcare ($482).
Total Amount
$1,407
General + Research + Ownership
Payments
27
Total payment records
General Amount
$1,407
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Baxter Healthcare | $482 |
| Edwards Lifesciences Corporation | $232 |
| W. L. Gore & Associates, Inc. | $155 |
| ABIOMED | $105 |
| Ethicon US, LLC | $100 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-10-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111017000277 | I | Physician Assistant | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13 | 13 | $0 |
| 33508 | Harvest of vein using an endoscope | 11 | 11 | $0 |
| 33533 | Coronary artery bypass using artery graft, 1 graft | 11 | 11 | $0 |
Insurance plans in this area (ZIP 80907)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | CO | 33533 | Heart artery bypass to repair one artery | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CO | |
| Radiation Oncology | TX | |
| - | CO | |
| Hospitalist, General Practice, Family Practice | CO | |
| Cardiovascular Disease (Cardiology) | NM | |
| Family Practice | OK | |
| Internal Medicine | CO | |
| - | IL | |
| H E M A T O L O G Y/ O N C O L O G Y | TX | |
| Internal Medicine | PA |
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