DR. DUSTIN CLIFTON DERRICK (M.D.) – Plastic Surgery Physician, NPI 1295049070
Plastic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
589 PLASTIC AND RECONSTRUCTIVE SURGERY in TX
Provider Addresses for DR. DUSTIN CLIFTON DERRICK (M.D.)
800 8TH AVE STE 206
FORT WORTH, TX 761042619
Phone: (817) 529-4314
Fax: (817) 334-0491
Type: Mailing
800 12TH AVE STE 100
FORT WORTH, TX 761042519
Phone: (817) 810-0770
Fax: (817) 820-0242
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 42 Open Payments records for all available years, with a total value of $1,525.
Total Amount is formed as General ($1,525) + Research ($0) + Ownership ($0) = $1,525.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($926).
Total Amount
$1,525
General + Research + Ownership
Payments
42
Total payment records
General Amount
$1,525
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $926 |
| Kerecis Limited | $228 |
| LifeNet Health | $174 |
| Access Pro Medical, LLC | $48 |
| Integra LifeSciences Corporation | $44 |
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: 2018-09-06
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 |
|---|---|---|---|---|
| I20180906001067 | I | Plastic And Reconstructive Surgery | TX | 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 |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 47 | 32 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 76104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Plastic And Reconstructive Surgery | NC | |
| Plastic And Reconstructive Surgery, Otolaryngology | TX | |
| Plastic And Reconstructive Surgery | TX |
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