DEREK HENDRICKSON (PA-C) – Medical Physician Assistant, NPI 1043857196
Medical Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for DEREK HENDRICKSON (PA-C)
1200 SIXTH ST STE 200
TRAVERSE CITY, MI 496842369
Phone: (231) 935-5800
Fax: (231) 935-5799
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 11 Open Payments records for all available years, with a total value of $204.
Total Amount is formed as General ($204) + Research ($0) + Ownership ($0) = $204.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Novo Nordisk Inc ($69).
Total Amount
$204
General + Research + Ownership
Payments
11
Total payment records
General Amount
$204
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $69 |
| Astellas Pharma US Inc | $29 |
| SANOFI-AVENTIS U.S. LLC | $22 |
| Dexcom, Inc. | $20 |
| Exact Sciences Corporation | $18 |
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: 2019-12-23
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 |
|---|---|---|---|---|
| I20191223000688 | I | Physician Assistant | MI | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 109 | 84 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 108 | 72 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 27 | 27 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 24 | 24 | $0 |
Insurance plans in this area (ZIP 49684)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Nurse Practitioner | MI |
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