DERRICK J SANDERSON – Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician, NPI 1043577448
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
966 OBSTETRICS/GYNECOLOGY in IN
Provider Addresses for DERRICK J SANDERSON
4199 GATEWAY BLVD STE 3500
NEWBURGH, IN 476307909
Phone: (812) 858-5990
Fax: (812) 858-5955
Type: Mailing
4199 Gateway Blvd Ste 3500
Newburgh, IN 476307909
Phone: (812) 858-5950
Fax: (812) 858-5955
Type: Location
1540 Maple Rd
Williamsville, NY 142213647
Phone: (716) 568-3600
Type: Location
1836 SOUTH AVE
LA CROSSE, WI 546015429
Phone: (608) 782-7300
Type: Mailing
1122 W HIGHWAY 61
WINONA, MN 559871957
Phone: (608) 782-7300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $384.
Total Amount is formed as General ($384) + Research ($0) + Ownership ($0) = $384.
Last reported payment date: 2023-12-12 • Largest payer in this snapshot: Medtronic, Inc. ($167).
Total Amount
$384
General + Research + Ownership
Payments
13
Total payment records
General Amount
$384
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $167 |
| Aspira Women's Health Inc | $82 |
| Exeltis, USA Inc. | $38 |
| Axonics, Inc. | $32 |
| Pharmacosmos Therapeutics Inc. | $20 |
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: 2024-11-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20160808002692 | I | Obstetrics/Gynecology | NY | TBD |
| I20210920000663 | I | Obstetrics/Gynecology | MN | TBD |
| I20241118002276 | I | Obstetrics/Gynecology | WI | 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 |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 5,400 | 24 | $0 |
| 51701 | Insertion of temporary bladder tube | 94 | 77 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 71 | 61 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 51 | 42 | $0 |
| 52287 | Exam with injections of chemical for destruction of bladder using an endoscope | 50 | 24 | $0 |
Insurance plans in this area (ZIP 47630)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| P S Y C H I A T R Y | WI | |
| Physician Assistant | WI | |
| - | WI | |
| - | WI | |
| Family Practice | WI | |
| Nurse Practitioner | WI | |
| - | IL | |
| - | WI | |
| Gastroenterology, Internal Medicine | WI |
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