MR. DEREK BRENT KORDENBROCK (NP) – Adult Health Nurse Practitioner, NPI 1245579408
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
Provider Addresses for MR. DEREK BRENT KORDENBROCK (NP)
2620 E BARNETT RD STE H
MEDFORD, OR 975048383
Phone: (541) 789-4281
Fax: (541) 789-2558
Type: Mailing
625 SW RAMSEY AVE STE A
GRANTS PASS, OR 975275808
Phone: (541) 507-2300
Fax: (541) 507-2301
Type: Location
815 N CENTRAL AVE STE C
MEDFORD, OR 975015873
Phone: (541) 734-9030
Fax: (541) 734-9885
Type: Mailing
1345 CENTER DR UNIT A
MEDFORD, OR 975017945
Phone: (541) 734-9030
Fax: (541) 734-9885
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $392.
Total Amount is formed as General ($392) + Research ($0) + Ownership ($0) = $392.
Last reported payment date: 2024-09-12 • Largest payer in this snapshot: Gilead Sciences, Inc. ($290).
Total Amount
$392
General + Research + Ownership
Payments
6
Total payment records
General Amount
$392
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Gilead Sciences, Inc. | $290 |
| Lilly USA, LLC | $59 |
| Otsuka America Pharmaceutical, Inc. | $42 |
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: 2016-10-24
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 |
|---|---|---|---|---|
| I20161024001229 | I | Nurse Practitioner | OR | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97504)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Nurse Practitioner | PA | |
| - | OR | |
| Physician Assistant | OR | |
| Physician Assistant | OR | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | MT | |
| - | OR | |
| Physician Assistant | OR |
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