JOHN BURTON DERRICK – Medical Physician Assistant, NPI 1932253606
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
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Provider Addresses for JOHN BURTON DERRICK
300, Arlington Drive, Vidalia, Toombs County, Georgia, 30474, United States
PO BOX 645
VIDALIA, GA 30475
Phone: (912) 538-0830
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $94.
Total Amount is formed as General ($94) + Research ($0) + Ownership ($0) = $94.
Last reported payment date: 2023-12-07 • Largest payer in this snapshot: Axonics, Inc. ($79).
Total Amount
$94
General + Research + Ownership
Payments
2
Total payment records
General Amount
$94
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axonics, Inc. | $79 |
| Phadia US Inc. | $15 |
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: 2011-01-13
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 |
|---|---|---|---|---|
| I20110113000620 | I | Physician Assistant | GA | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 195 | 27 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 113 | 88 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 49 | 44 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 44 | 22 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 36 | $0 |
Insurance plans in this area (ZIP 30475)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | GA |
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